Provider Demographics
NPI:1679463830
Name:ZAVALA, JENNIE GAIL (RBT)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:GAIL
Last Name:ZAVALA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 W PARKTOWN DR
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-5734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10777 WESTHEIMER RD STE 1100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3462
Practice Address - Country:US
Practice Address - Phone:346-499-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician