Provider Demographics
NPI:1912237140
Name:ZEUG, NICOLE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ZEUG
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112250
Mailing Address - Street 2:UNIVERSITY OF FLORIDA
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32611-2250
Mailing Address - Country:US
Mailing Address - Phone:352-273-2184
Mailing Address - Fax:352-392-4098
Practice Address - Street 1:749 CENTER DR
Practice Address - Street 2:SUITE 375
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-2250
Practice Address - Country:US
Practice Address - Phone:352-273-2184
Practice Address - Fax:352-392-4098
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-08-4904103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst