Provider Demographics
NPI:1568913390
Name:ZUCKER, MICHELLE (MA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ZUCKER
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 1:1692 S EUDORA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3826
Mailing Address - Country:US
Mailing Address - Phone:303-319-9062
Mailing Address - Fax:
Practice Address - Street 1:25 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-5195
Practice Address - Country:US
Practice Address - Phone:720-275-5728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator