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NPI Code Detail

MEDICARE: MISS MARY CHRISTINE ZIMMERMAN QMHS

MEDICARE: MISS MARY CHRISTINE ZIMMERMAN QMHS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1548737158
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARY CHRISTINE ZIMMERMAN QMHS
Provider Business Mailing Address
First Line : 4062 CHARTER OAK WAY
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6090
Country : US
Telephone Number : 419-206-2566
Fax Number :
Provider Business Practice Location Address
First Line : 1490 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2140
Country : US
Telephone Number : 614-252-0731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2018
Last Update Date : 08/14/2019

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Directions to “ MISS MARY CHRISTINE ZIMMERMAN QMHS” Practice Location

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