Provider Demographics
NPI:1194868315
Name:ZECCA, DENISE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ANN
Last Name:ZECCA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 W DUNBAR CAVE RD
Mailing Address - Street 2:307
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6087
Mailing Address - Country:US
Mailing Address - Phone:931-920-5978
Mailing Address - Fax:931-552-3200
Practice Address - Street 1:151 W DUNBAR CAVE RD
Practice Address - Street 2:307
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6087
Practice Address - Country:US
Practice Address - Phone:931-920-5978
Practice Address - Fax:931-552-3200
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2321103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982981Medicare ID - Type Unspecified