Provider Demographics
NPI:1538490164
Name:ZAPACH, NICOLENE MARY (MA)
Entity Type:Individual
Prefix:MS
First Name:NICOLENE
Middle Name:MARY
Last Name:ZAPACH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2320
Mailing Address - Country:US
Mailing Address - Phone:412-561-3815
Mailing Address - Fax:
Practice Address - Street 1:206 BIRCH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT LEBANON
Practice Address - State:PA
Practice Address - Zip Code:15228-2320
Practice Address - Country:US
Practice Address - Phone:412-561-3815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007382L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist