Provider Demographics
NPI:1164666558
Name:DUGGER, ZACHARIAH THOMAS (MA, LLP, BCBA)
Entity Type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:THOMAS
Last Name:DUGGER
Suffix:
Gender:M
Credentials:MA, LLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 TAMSIN AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-4002
Mailing Address - Country:US
Mailing Address - Phone:269-303-5931
Mailing Address - Fax:
Practice Address - Street 1:3320 TAMSIN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-4002
Practice Address - Country:US
Practice Address - Phone:269-303-5931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361003361103T00000X
MI1073504103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst