Provider Demographics
NPI:1154691871
Name:ZEGERS, ABBY D (MS, IADC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:D
Last Name:ZEGERS
Suffix:
Gender:F
Credentials:MS, IADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8527 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1069
Mailing Address - Country:US
Mailing Address - Phone:515-402-5422
Mailing Address - Fax:515-224-5802
Practice Address - Street 1:8527 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1069
Practice Address - Country:US
Practice Address - Phone:515-402-5422
Practice Address - Fax:515-224-5802
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10065101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)