Healthcare Provider Details

I. General information

NPI: 1326903543
Provider Name (Legal Business Name): TRACI ZUZELSKI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 68TH ST SE
GRAND RAPIDS MI
49548-6995
US

IV. Provider business mailing address

300 68TH ST SE
GRAND RAPIDS MI
49548-6995
US

V. Phone/Fax

Practice location:
  • Phone: 616-455-5000
  • Fax: 616-281-6459
Mailing address:
  • Phone: 616-455-5000
  • Fax: 616-281-6459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5201004886
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: