Provider Demographics
NPI: | 1386473593 |
---|---|
Name: | ZEBRA PSYCHIATRIC AND WELLNESS SERVICES, LLC |
Entity type: | Organization |
Organization Name: | ZEBRA PSYCHIATRIC AND WELLNESS SERVICES, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | NP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EMILY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | REES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 614-582-9805 |
Mailing Address - Street 1: | 1747 OLENTANGY RIVER RD # 1034 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBUS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43212-1453 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 171 CHARRING CROSS DR S |
Practice Address - Street 2: | |
Practice Address - City: | WESTERVILLE |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43081-2862 |
Practice Address - Country: | US |
Practice Address - Phone: | 740-240-0614 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-07-29 |
Last Update Date: | 2024-09-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Single Specialty |