Healthcare Provider Details

I. General information

NPI: 1265739528
Provider Name (Legal Business Name): BARBARA JEAN ZOOG LICDC,SAP,CTT,LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8563 REFUGEE RD
PICKERINGTON OH
43147-9639
US

IV. Provider business mailing address

8684 EASTON DR
PICKERINGTON OH
43147-9607
US

V. Phone/Fax

Practice location:
  • Phone: 614-837-8000
  • Fax:
Mailing address:
  • Phone: 614-205-9714
  • Fax: 614-920-1807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number923378
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: