MEDICARE: MRS. JACQUELINE MARY ZSCHAU LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1938	KY

General Provider Information

NPI Number	:	1063698074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JACQUELINE MARY ZSCHAU LCSW

Provider Business Mailing Address
First Line	:	26 ANDREW CIR
Second Line	:
City	:	COLD SPRING
State	:	KY
Zip	:	41076-1888
Country	:	US
Telephone Number	:	859-442-5756
Fax Number	:	859-442-5269

Provider Business Practice Location Address
First Line	:	26 ANDREW CIR
Second Line	:
City	:	COLD SPRING
State	:	KY
Zip	:	41076-1888
Country	:	US
Telephone Number	:	859-442-5756
Fax Number	:	859-442-5269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2008
Last Update Date	:	01/21/2008

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