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General NPI Number Information
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NPI Number | 1710190244
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Entity Type | Individual
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Provider Name | DIANE CAROL ZUCKSCHWERDT MA,CCC-A
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 818 W KING ST STE 301
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City | OWOSSO
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State | MI
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Zip | 48867-2117
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Country | US
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Telephone | 989-729-4800
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Fax | 989-729-4810
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Provider Business Mailing Address
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Address Line | 818 W KING ST STE 301
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City | OWOSSO
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State | MI
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Zip | 48867-2117
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Country | US
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Telephone | 989-729-4800
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Fax | 989-729-4810
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 1601000220
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License Number State | MI
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