Provider Demographics
NPI:1538809082
Name:ZANE, TRICIA LYNN (CSWA)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:LYNN
Last Name:ZANE
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3103
Mailing Address - Country:US
Mailing Address - Phone:530-515-4177
Mailing Address - Fax:
Practice Address - Street 1:993 SISKIYOU BLVD STE 4
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3943
Practice Address - Country:US
Practice Address - Phone:530-515-4177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A124941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical