Provider Demographics
NPI:1427713551
Name:ZINKAN, CHERYL
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ZINKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 E CARSON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7402
Mailing Address - Country:US
Mailing Address - Phone:480-309-1667
Mailing Address - Fax:
Practice Address - Street 1:401 W BASELINE RD STE 210
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5350
Practice Address - Country:US
Practice Address - Phone:480-307-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist