Most Relevant Information
Provider Data
| NPI Number: | 1003590308 |
| Provider Name: | NICOLE ZIMMERMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 2202010864 |
Most Important Dates
| Enumeration Date: | 06/15/2023 |
| Last Updated: | 06/15/2023 |
Provider Practice Location
12581 MILSTEAD WAY STE 302
WOODBRIDGE
VA
221925446
Practice Location Phone/Fax
| Phone: | 7032397336 |
| Fax: |
Provider Mailing Location
12581 MILSTEAD WAY STE 302
WOODBRIDGE
VA
221925446
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |