Basic Information
| Provider Information | |||||||||
| NPI: | 1902014871 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZAKSEK | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | FRANK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 377 MDG | ||||||||
| Address2: | 2050A SECOND ST SE | ||||||||
| City: | KIRTLAND AFB | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871175522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058463562 | ||||||||
| FaxNumber: | 5058463295 | ||||||||
| Practice Location | |||||||||
| Address1: | 377 MDG | ||||||||
| Address2: | 2050A SECOND ST SE | ||||||||
| City: | KIRTLAND AFB | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871175522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5058463562 | ||||||||
| FaxNumber: | 5058463295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.