Provider Demographics
NPI:1912471046
Name:ZANZELUK, NATACHA (MA)
Entity type:Individual
Prefix:
First Name:NATACHA
Middle Name:
Last Name:ZANZELUK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 114TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2802
Mailing Address - Country:US
Mailing Address - Phone:332-268-7494
Mailing Address - Fax:212-727-6805
Practice Address - Street 1:10920 MOSS PARK RD STE 130
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6087
Practice Address - Country:US
Practice Address - Phone:407-930-4339
Practice Address - Fax:407-745-0316
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health