Provider Demographics
NPI:1649927575
Name:ZUBRICKI, AUTUMN BROOKE
Entity type:Individual
Prefix:MS
First Name:AUTUMN
Middle Name:BROOKE
Last Name:ZUBRICKI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AUTUMN
Other - Middle Name:BROOKE
Other - Last Name:ZUBRICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:531 ESSEX AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-2004
Mailing Address - Country:US
Mailing Address - Phone:978-277-8278
Mailing Address - Fax:
Practice Address - Street 1:3 BLACKBURN CTR
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2268
Practice Address - Country:US
Practice Address - Phone:978-277-8278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor