Provider Demographics
NPI:1679809214
Name:SHNEK, ZACHARY MARTIN (PHD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:MARTIN
Last Name:SHNEK
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 1:13198 N PIER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658-4228
Mailing Address - Country:US
Mailing Address - Phone:520-306-6028
Mailing Address - Fax:
Practice Address - Street 1:7360 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2305
Practice Address - Country:US
Practice Address - Phone:520-306-6028
Practice Address - Fax:520-579-0798
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4053103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical