Healthcare Provider Details

I. General information

NPI: 1508490962
Provider Name (Legal Business Name): ZUCKER & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9510 W SAHARA AVE STE 110
LAS VEGAS NV
89117-8804
US

IV. Provider business mailing address

9510 W SAHARA AVE STE 110
LAS VEGAS NV
89117-8804
US

V. Phone/Fax

Practice location:
  • Phone: 702-641-2422
  • Fax:
Mailing address:
  • Phone: 702-641-2422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. IRENE ZUCKER
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 702-641-2422