Healthcare Provider Details

I. General information

NPI: 1548678576
Provider Name (Legal Business Name): SELF MATTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7989 WASHINGTON WOODS DR
DAYTON OH
45459-4026
US

IV. Provider business mailing address

7989 WASHINGTON WOODS DR
DAYTON OH
45459-4026
US

V. Phone/Fax

Practice location:
  • Phone: 937-972-5933
  • Fax: 855-745-5522
Mailing address:
  • Phone: 937-972-5933
  • Fax: 855-745-5522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number7181
License Number StateOH

VIII. Authorized Official

Name: APARNA ZIMMERMAN
Title or Position: SOLE MEMBER
Credential: PSYD
Phone: 937-972-5933