Provider Demographics
NPI:1336638451
Name:VAN ZEE, TRACY NEDINE
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:NEDINE
Last Name:VAN ZEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:IA
Mailing Address - Zip Code:51521-3510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 N ELM ST
Practice Address - Street 2:
Practice Address - City:AVOCA
Practice Address - State:IA
Practice Address - Zip Code:51521-3510
Practice Address - Country:US
Practice Address - Phone:712-307-6015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health