Provider Demographics
NPI:1336800952
Name:ZETZSCHE, TIMOTHY MARK (LPCC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:MARK
Last Name:ZETZSCHE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1708 NORTHERN VIOLA LN NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-6948
Mailing Address - Country:US
Mailing Address - Phone:608-469-3031
Mailing Address - Fax:507-252-8217
Practice Address - Street 1:917 N BROADWAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-6843
Practice Address - Country:US
Practice Address - Phone:507-252-8218
Practice Address - Fax:507-252-8217
Is Sole Proprietor?:No
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN3149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional