Healthcare Provider Details

I. General information

NPI: 1326617101
Provider Name (Legal Business Name): BRIANNA ZIMMERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WESTPORT AVE
NORWALK CT
06851-3915
US

IV. Provider business mailing address

14 WESTPORT AVE
NORWALK CT
06851-3915
US

V. Phone/Fax

Practice location:
  • Phone: 800-860-6656
  • Fax:
Mailing address:
  • Phone: 800-860-6656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-73201
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: