Provider Demographics
NPI:1902956147
Name:ZUZEK, MICHELLE COCHRAN (MSW LISW CPRP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:COCHRAN
Last Name:ZUZEK
Suffix:
Gender:F
Credentials:MSW LISW CPRP
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:RUTH
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:5524 BENTON AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2204
Mailing Address - Country:US
Mailing Address - Phone:952-926-5784
Mailing Address - Fax:952-938-7934
Practice Address - Street 1:15 9TH AVE S
Practice Address - Street 2:VAIL PLACE
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343
Practice Address - Country:US
Practice Address - Phone:952-938-9622
Practice Address - Fax:952-938-7934
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5290104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker