Provider Demographics
NPI:1972113876
Name:ZAK, VALERIE JANEEN (MA, BCBA, COBA, LBA)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JANEEN
Last Name:ZAK
Suffix:
Gender:F
Credentials:MA, BCBA, COBA, LBA
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:JANEEN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:490 WHITE POND DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1122
Practice Address - Country:US
Practice Address - Phone:330-777-3284
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-44337103K00000X
KY296097103K00000X
OHCOBA.00732103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-20-44337OtherBCBA CERTIFICATE