Basic Information
Provider Information
NPI: 1003292681
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHANG
FirstName: KE ANNE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193564658
FaxNumber: 3193562587
Practice Location
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193564658
FaxNumber: 3193562587
Other Information
ProviderEnumerationDate: 08/05/2015
LastUpdateDate: 03/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X111445IAN Behavioral Health & Social Service ProvidersPsychologist 
103TB0200X111445IAN Behavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
103TH0004X111445IAN Behavioral Health & Social Service ProvidersPsychologistHealth
103TH0100X111445IAN Behavioral Health & Social Service ProvidersPsychologistHealth Service
103TP2701X111445IAN Behavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
103TC0700X111445IAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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