Provider Demographics
NPI:1356785562
Name:ZOBEL, JESSICA (MS SPECIAL EDUCATION)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ZOBEL
Suffix:
Gender:F
Credentials:MS SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:TUPPER LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12986-1028
Mailing Address - Country:US
Mailing Address - Phone:518-359-7518
Mailing Address - Fax:
Practice Address - Street 1:12 MOHAWK ST
Practice Address - Street 2:
Practice Address - City:TUPPER LAKE
Practice Address - State:NY
Practice Address - Zip Code:12986-1028
Practice Address - Country:US
Practice Address - Phone:518-359-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist