Healthcare Provider Details
I. General information
NPI: 1225378284
Provider Name (Legal Business Name): BARBARA C ZHUCHKAN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/27/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 N GEORGIA AVE
HOWEY IN THE HILLS FL
34737-3122
US
IV. Provider business mailing address
16021 ST CLAIR ST
CLERMONT FL
34714-6517
US
V. Phone/Fax
- Phone: 352-253-6790
- Fax:
- Phone: 315-632-2798
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 023484-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SA 12863 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: