Provider Demographics
NPI:1972319515
Name:ZENDER, OLIVIA MARIE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARIE
Last Name:ZENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-1742
Mailing Address - Country:US
Mailing Address - Phone:419-619-6310
Mailing Address - Fax:
Practice Address - Street 1:125 N COLUMBUS ST STE 2
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-1934
Practice Address - Country:US
Practice Address - Phone:567-560-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2411687104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker