Provider Demographics
NPI:1073290276
Name:TUCKER, ZACHARY R (RBT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:R
Last Name:TUCKER
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 CONGRESSIONAL BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5400
Mailing Address - Country:US
Mailing Address - Phone:317-249-2242
Mailing Address - Fax:844-289-6798
Practice Address - Street 1:3777 HALEY DRIVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-2608
Practice Address - Country:US
Practice Address - Phone:317-249-2242
Practice Address - Fax:844-289-6798
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
INRBT-22-211511106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician