Healthcare Provider Details

I. General information

NPI: 1588502025
Provider Name (Legal Business Name): COLLENE ZUCHOWSKI RN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4538 N 5300 W
CEDAR CITY UT
84721-4508
US

IV. Provider business mailing address

4538 N 5300 W
CEDAR CITY UT
84721-4508
US

V. Phone/Fax

Practice location:
  • Phone: 805-341-2160
  • Fax:
Mailing address:
  • Phone: 805-341-2160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number91596193102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: