Provider Demographics
NPI:1417538208
Name:ZAK, MONICA MARIE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:MARIE
Last Name:ZAK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 DENNIS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2988
Mailing Address - Country:US
Mailing Address - Phone:859-559-6044
Mailing Address - Fax:
Practice Address - Street 1:112 DENNIS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2988
Practice Address - Country:US
Practice Address - Phone:859-559-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst