Healthcare Provider Details

I. General information

NPI: 1467316638
Provider Name (Legal Business Name): JULIE ROSE ZIBREG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 BOARDMAN CANFIELD RD STE 305
YOUNGSTOWN OH
44512-4230
US

IV. Provider business mailing address

7658 HUNTINGTON DR
YOUNGSTOWN OH
44512-4035
US

V. Phone/Fax

Practice location:
  • Phone: 330-540-0878
  • Fax: 234-287-6077
Mailing address:
  • Phone: 330-540-0878
  • Fax: 234-287-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.007438
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: