Individual
JOHN MICHAEL ZIVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD HSPP
Contact information
Practice address
32 RIDGE RD, MUNSTER, IN 46321-1518
(219) 836-8806
(219) 962-4042
Mailing address
32 RIDGE RD, MUNSTER, IN 46321-1518
(219) 836-8006
(219) 962-4042
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040099A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203122
NONE
—
05
—
100218620A
—
IN
Enumeration date
08/01/2005
Last updated
03/14/2010
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