Provider Demographics
NPI:1841485836
Name:ZUCKER, MARC TODD (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:TODD
Last Name:ZUCKER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9510 W SAHARA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8804
Mailing Address - Country:US
Mailing Address - Phone:702-641-2422
Mailing Address - Fax:702-893-9655
Practice Address - Street 1:9510 W SAHARA AVE STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8804
Practice Address - Country:US
Practice Address - Phone:702-641-2422
Practice Address - Fax:702-893-9655
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0530103TF0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic