Provider Demographics
NPI:1710196613
Name:ZUCAL, BARBARA I (MS)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:I
Last Name:ZUCAL
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 1:15152 TRUMAN MANOR LN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-4467
Mailing Address - Country:US
Mailing Address - Phone:301-274-3898
Mailing Address - Fax:301-274-3867
Practice Address - Street 1:15152 TRUMAN MANOR LN
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-4467
Practice Address - Country:US
Practice Address - Phone:301-274-3898
Practice Address - Fax:301-274-3867
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist