Provider Demographics
NPI:1326911454
Name:ZANCLAN, MARIANNE ASTRIDE HOUNDEMAN
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:ASTRIDE HOUNDEMAN
Last Name:ZANCLAN
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 1:25200 ROCKSIDE RD APT 310
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1909
Mailing Address - Country:US
Mailing Address - Phone:757-274-7264
Mailing Address - Fax:
Practice Address - Street 1:25200 ROCKSIDE RD APT 310
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1909
Practice Address - Country:US
Practice Address - Phone:757-274-7264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical