Provider Demographics
NPI:1437656667
Name:ZUIDEMA, ANNA MAE (MA, NCC, TLMHC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MAE
Last Name:ZUIDEMA
Suffix:
Gender:F
Credentials:MA, NCC, TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 VAN BUREN DR
Mailing Address - Street 2:
Mailing Address - City:VAN METER
Mailing Address - State:IA
Mailing Address - Zip Code:50261-9742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1103 BUCKEYE AVE STE 104
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8120
Practice Address - Country:US
Practice Address - Phone:515-337-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health