Doctor Name: | MR. GERALD A ZICKLER |
NPI Number: | 1558412544 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LADC |
License Number: | 000273 |
Business Practice Address: | 297 Summer St St Johnsbury, VT - 05819 |
Business Phone Number: | 8027481682 |
Business Fax Number: | 8027480211 |
Mailing Address: | 79 Boynton Ave, ST JOHNSBURY |
State: | VT |
Postal Code: | 05819 |
Phone Number: | 8027481682 |
Fax Number: | |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 000273 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |