Organization
IDA ZEKTICK ZACK PHD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IDA ZACK PH.D. (PSYCHOLOGIST)
(248) 546-6711
Entity
Organization
Contact information
Practice address
217 KNOWLES ST, SUITE 100, ROYAL OAK, MI 48067-2767
(248) 546-6711
(248) 546-5090
Mailing address
217 KNOWLES ST, SUITE 100, ROYAL OAK, MI 48067-2767
(248) 546-6711
(248) 546-5090
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301001930
MI
Other
Enumeration date
06/10/2010
Last updated
10/20/2010
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