Individual
RON JOSEPH ZUCHORA-WALSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CLINICALSOCIALWORKER
Contact information
Practice address
5939 PORTLAND AVE SOUTH, MINNEAPOLIS, MN 55417
(612) 689-4444
(612) 254-8244
Mailing address
5733 14TH AVE SOUTH, MINNEAPOLIS, MN 55417-1001
(612) 719-0965
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
24636
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24636
NEW ADDITIONAL LICENSE #
MN
05
—
642492100
—
MN
Enumeration date
12/14/2007
Last updated
11/16/2021
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