Provider Demographics
NPI:1518198175
Name:MIRIAM ZICHT, PH.D., P.A.
Entity Type:Organization
Organization Name:MIRIAM ZICHT, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZICHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:352-584-2232
Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34656-0264
Mailing Address - Country:US
Mailing Address - Phone:352-584-2232
Mailing Address - Fax:
Practice Address - Street 1:5315 TROUBLE CREEK RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4949
Practice Address - Country:US
Practice Address - Phone:352-584-2232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5554103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty