Provider Demographics
NPI:1902559024
Name:ZULUAGA, DEANA MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:DEANA
Middle Name:MARIE
Last Name:ZULUAGA
Suffix:
Gender:F
Credentials:MS
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 65190
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-0004
Mailing Address - Country:US
Mailing Address - Phone:904-614-0152
Mailing Address - Fax:904-579-4336
Practice Address - Street 1:2575 COUNTY ROAD 220 STE 108
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-6542
Practice Address - Country:US
Practice Address - Phone:904-614-0152
Practice Address - Fax:904-579-4336
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health