Provider Demographics
NPI:1992311617
Name:NACE, ZOE (RBT)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:NACE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ZEE
Other - Middle Name:
Other - Last Name:NACE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:451 WILCOX AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3623
Mailing Address - Country:US
Mailing Address - Phone:907-888-9592
Mailing Address - Fax:
Practice Address - Street 1:326 DRIVEWAY ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-2807
Practice Address - Country:US
Practice Address - Phone:907-357-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician