Provider Demographics
NPI:1649223397
Name:ZAHOUREK, ROTHLYN P (PHD APRN BC)
Entity Type:Individual
Prefix:DR
First Name:ROTHLYN
Middle Name:P
Last Name:ZAHOUREK
Suffix:
Gender:F
Credentials:PHD APRN BC
Other - Prefix:MS
Other - First Name:RORRY
Other - Middle Name:
Other - Last Name:ZAHOUREK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD APRN BC
Mailing Address - Street 1:196 N PLEASANT ST
Mailing Address - Street 2:STE 15
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1721
Mailing Address - Country:US
Mailing Address - Phone:413-253-3210
Mailing Address - Fax:413-323-5376
Practice Address - Street 1:196 N PLEASANT ST
Practice Address - Street 2:STE 15
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1721
Practice Address - Country:US
Practice Address - Phone:413-253-3210
Practice Address - Fax:413-323-5376
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA185595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAZANS0060Medicare ID - Type UnspecifiedPSYCH CNS