Healthcare Provider Details

I. General information

NPI: 1821373861
Provider Name (Legal Business Name): STEPHANIE LOUISE ZANE OT/R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE LOUISE ZANE OT/R

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 SIERRA ROSE DR STE A
RENO NV
89511-2078
US

IV. Provider business mailing address

1850 JAMBOREE DR
RENO NV
89521-4058
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-4800
  • Fax: 775-324-1143
Mailing address:
  • Phone: 775-851-1269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number08-0045
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: