Provider Demographics
NPI:1891544342
Name:ZARAZUA, MYKEERAH SHANEE MILLER (APSW)
Entity type:Individual
Prefix:
First Name:MYKEERAH
Middle Name:SHANEE MILLER
Last Name:ZARAZUA
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:MYKEERAH
Other - Middle Name:SHANEE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:740 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1514
Mailing Address - Country:US
Mailing Address - Phone:715-347-6622
Mailing Address - Fax:
Practice Address - Street 1:1191 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-6364
Practice Address - Country:US
Practice Address - Phone:715-818-6443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI132682-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker