Healthcare Provider Details

I. General information

NPI: 1962707232
Provider Name (Legal Business Name): JESSICA ANN ZAPOTECHNE MA, ATR-BC, LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 01/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 BROADWAY 4TH FLOOR, ROOM 15
NEW YORK NY
10013-3926
US

IV. Provider business mailing address

373 BROADWAY 4TH FLOOR, ROOM 15
NEW YORK NY
10013-3926
US

V. Phone/Fax

Practice location:
  • Phone: 718-928-5644
  • Fax:
Mailing address:
  • Phone: 718-928-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: