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General NPI Number Information
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NPI Number | 1205183506
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Entity Type | Individual
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Provider Name | DIANE ZIMMERMAN SCHOOL PSYCHOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 600 CHARLES ST
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City | SUDLERSVILLE
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State | MD
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Zip | 21668-1532
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Country | US
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Telephone | 410-438-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 202 CHESTERFIELD AVE
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City | CENTREVILLE
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State | MD
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Zip | 21617-1308
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Country | US
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Telephone | 410-758-2403
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Fax | 410-758-8200
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 53946
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License Number State | DE
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