Provider Information for 1720117401
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Mrs. JACQUELYN ELAINE ZIMMERMAN LCPC
Sex: Female
NPI: 1720117401
Last Updated: 2009-07-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1720117401 | ||||||||
| Enumeration Date | 2007-03-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 27429 WOODLAND RD SEAFORD, DE 19973 United States Phone: 302-536-1566 | Fax: | ||||||||
| Primary Practice Address | 3680 WARWICK RD EAST NEW MARKET, MD 21631-1420 United States Phone: 410-685-2550 | Fax: | ||||||||
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