Healthcare Provider Details

I. General information

NPI: 1073154902
Provider Name (Legal Business Name): ANDREA NICOLE ZUCHORA MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 05/09/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 EAST JEFFERSON
DETROIT MI
48214
US

IV. Provider business mailing address

545 S KELLER RD UNIT 1331
ORLANDO FL
32810-6306
US

V. Phone/Fax

Practice location:
  • Phone: 888-813-8326
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-40268
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-40268
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: