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General NPI Number Information
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NPI Number | 1114522315
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Entity Type | Individual
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Provider Name | DEBORAH ZIMLICH
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Gender | Female
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 2518 FRANKFORT AVE
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City | LOUISVILLE
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State | KY
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Zip | 40206-2530
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Country | US
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Telephone | 502-673-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 206 BONNER AVE
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City | LOUISVILLE
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State | KY
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Zip | 40207-2257
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Country | US
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Telephone | 502-645-5769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 251515
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 289969
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License Number State | KY
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