Provider Demographics
NPI:1225378284
Name:ZHUCHKAN, BARBARA C (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:C
Last Name:ZHUCHKAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16021 ST CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-6517
Mailing Address - Country:US
Mailing Address - Phone:315-632-2798
Mailing Address - Fax:
Practice Address - Street 1:525 N GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:HOWEY IN THE HILLS
Practice Address - State:FL
Practice Address - Zip Code:34737-3122
Practice Address - Country:US
Practice Address - Phone:352-253-6790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023484-1235Z00000X
FLSA 12863235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA 12863OtherFLORIDA STATE DOH LICENSE NUMBER
14098293OtherASHA MEMBER NUMBER
NY023484-1OtherNEW YORK STATE LICENSE