Healthcare Provider Details

I. General information

NPI: 1730681040
Provider Name (Legal Business Name): VICTORIA ZAVODISCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIKA ZAVODISCHER

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 S CENTRAL AVE
COLUMBUS OH
43223-1301
US

IV. Provider business mailing address

199 S CENTRAL AVE
COLUMBUS OH
43223-1301
US

V. Phone/Fax

Practice location:
  • Phone: 614-278-0076
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: