Provider Demographics
NPI:1245863315
Name:ZAHRADKA, PATRICIA LYNN (COUNSELOR INTERN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:ZAHRADKA
Suffix:
Gender:F
Credentials:COUNSELOR INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8178
Mailing Address - Country:US
Mailing Address - Phone:701-541-7611
Mailing Address - Fax:
Practice Address - Street 1:901 28TH ST S STE B
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8743
Practice Address - Country:US
Practice Address - Phone:701-541-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)