Provider Demographics
NPI:1518705219
Name:ZUKAUSKIS, RONALD LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEE
Last Name:ZUKAUSKIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 KEELEY ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124-1383
Mailing Address - Country:US
Mailing Address - Phone:812-526-2681
Mailing Address - Fax:
Practice Address - Street 1:202 KEELEY ST
Practice Address - Street 2:
Practice Address - City:EDINBURGH
Practice Address - State:IN
Practice Address - Zip Code:46124-1383
Practice Address - Country:US
Practice Address - Phone:812-526-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1591158103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool