Provider Demographics
NPI:1104679133
Name:ZOUNLOME, NELSON O O (PHD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:O O
Last Name:ZOUNLOME
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E CARSON ST STE 250
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1957
Mailing Address - Country:US
Mailing Address - Phone:412-609-6762
Mailing Address - Fax:412-404-3972
Practice Address - Street 1:2000 E CARSON ST STE 250
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1957
Practice Address - Country:US
Practice Address - Phone:412-609-6762
Practice Address - Fax:412-404-3972
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical