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General NPI Number Information
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NPI Number | 1699406041
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Entity Type | Individual
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Provider Name | BRUNO ZIMMERMAN LPCA, NCC
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Gender | Male
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 670 MAIN ST S
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City | WOODBURY
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State | CT
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Zip | 06798-3738
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Country | US
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Telephone | 203-263-3175
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Fax |
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Provider Business Mailing Address
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Address Line | 670 MAIN ST S
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City | WOODBURY
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State | CT
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Zip | 06798-3738
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Country | US
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Telephone | 203-263-3175
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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 | 5491
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License Number State | CT
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