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General NPI Number Information
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NPI Number | 1194535674
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Entity Type | Individual
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Provider Name | CASSIE LAYNE ZIMMERMAN
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Gender | Female
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 4023 KENNETT PIKE
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City | WILMINGTON
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State | DE
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Zip | 19807-2018
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Country | US
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Telephone | 484-577-9928
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Fax |
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Provider Business Mailing Address
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Address Line | 7805 BRIDLE LN
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City | HARRISBURG
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State | PA
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Zip | 17112-9451
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Country | US
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Telephone | 717-409-4241
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 33680729
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License Number State | PA
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