Provider Demographics
NPI:1245681188
Name:MAXWELL, ZELCHA ZEQUARIA
Entity type:Individual
Prefix:MS
First Name:ZELCHA
Middle Name:ZEQUARIA
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BAHIA COURT TRAK
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-2941
Mailing Address - Country:US
Mailing Address - Phone:352-598-3319
Mailing Address - Fax:
Practice Address - Street 1:15833 N US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:CITRA
Practice Address - State:FL
Practice Address - Zip Code:32113-3155
Practice Address - Country:US
Practice Address - Phone:352-595-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist