Provider Demographics
NPI:1508694373
Name:ZARUCHES, NICOLLLE
Entity type:Individual
Prefix:
First Name:NICOLLLE
Middle Name:
Last Name:ZARUCHES
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 1:6380 NW 110TH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3735
Mailing Address - Country:US
Mailing Address - Phone:954-621-8524
Mailing Address - Fax:
Practice Address - Street 1:6380 NW 110TH AVE
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-3735
Practice Address - Country:US
Practice Address - Phone:954-621-8524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician