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NPI Code Detail

MEDICARE: MISS KORI ZIMMERMAN MA, LLP

MEDICARE:  MISS KORI  ZIMMERMAN  MA, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist6361001841MI
2103TC1900XCounseling Psychologist6361001841MI

General Provider Information

NPI Number : 1629345988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KORI ZIMMERMAN MA, LLP
Provider Business Mailing Address
First Line : 635 W HIGH ST
Second Line :
City : HASTINGS
State : MI
Zip : 49058-1123
Country : US
Telephone Number : 269-838-0825
Fax Number :
Provider Business Practice Location Address
First Line : 491 COLUMBIA AVE E STE 4
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49014-5468
Country : US
Telephone Number : 269-962-9611
Fax Number : 269-962-9612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2011
Last Update Date : 09/10/2020

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Directions to “ MISS KORI ZIMMERMAN MA, LLP” Practice Location

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