Provider Demographics
NPI:1770132342
Name:ZEHNDER, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ZEHNDER
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 1:240 N JAMES ST STE 203
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3171
Mailing Address - Country:US
Mailing Address - Phone:302-892-9210
Mailing Address - Fax:
Practice Address - Street 1:240 N JAMES ST STE 203
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:DE
Practice Address - Zip Code:19804-3171
Practice Address - Country:US
Practice Address - Phone:302-892-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-27335103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst