1902956147 NPI number — MRS. MICHELLE COCHRAN ZUZEK MSW LISW CPRP

Table of content: MRS. MICHELLE COCHRAN ZUZEK MSW LISW CPRP (NPI 1902956147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902956147 NPI number — MRS. MICHELLE COCHRAN ZUZEK MSW LISW CPRP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZUZEK
Provider First Name:
MICHELLE
Provider Middle Name:
COCHRAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LISW CPRP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COCHRAN
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902956147
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5524 BENTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDINA
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55436-2204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-926-5784
Provider Business Mailing Address Fax Number:
952-938-7934

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 9TH AVE S
Provider Second Line Business Practice Location Address:
VAIL PLACE
Provider Business Practice Location Address City Name:
HOPKINS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-938-9622
Provider Business Practice Location Address Fax Number:
952-938-7934
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  5290 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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