Provider Demographics
NPI:1093130775
Name:FALZETTA-SMITH, JENNIFER JOSEPHINE (LMT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOSEPHINE
Last Name:FALZETTA-SMITH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 ORANGE PLACE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-364-0152
Mailing Address - Fax:216-364-0157
Practice Address - Street 1:3690 ORANGE PLACE
Practice Address - Street 2:SUITE 175
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-364-0152
Practice Address - Fax:216-364-0157
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH33.017530225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist