Provider Demographics
NPI:1679973929
Name:ZENDER, TAMMY LOUISE (MSSA, LISW-S)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LOUISE
Last Name:ZENDER
Suffix:
Gender:F
Credentials:MSSA, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 CONSERVATORY DR STE B
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4289
Mailing Address - Country:US
Mailing Address - Phone:330-808-4542
Mailing Address - Fax:866-201-7270
Practice Address - Street 1:86 CONSERVATORY DR STE B
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4289
Practice Address - Country:US
Practice Address - Phone:330-808-4542
Practice Address - Fax:866-201-7270
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-23
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17005371041C0700X, 1041C0700X
104100000X, 1041S0200X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0241891Medicaid
OH0349547Medicaid
OH1235793910OtherNPI