Healthcare Provider Details

I. General information

NPI: 1083539308
Provider Name (Legal Business Name): ZACHARY CHRISTIAN M.S.ED., LSP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 STATE ROUTE 73
TRENTON OH
45067-9778
US

IV. Provider business mailing address

5005 STATE ROUTE 73
TRENTON OH
45067-9778
US

V. Phone/Fax

Practice location:
  • Phone: 513-867-3450
  • Fax: 513-867-7428
Mailing address:
  • Phone: 513-867-3450
  • Fax: 513-867-7428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01063
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: