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Organization

MJ ZIMMERMAN LPCC, LLC

Active
Other names
MJ Zimmerman LPCC
Organization subpart
No

Provider details

NPI number
Authorized official
MARY JANE ZIMMERMAN LPCC (SOLE MEMBER)
(505) 573-2339
Entity
Organization

Contact information

Practice address
4916 4TH ST NW, ALBUQUERQUE, NM 87107-3949
(505) 573-2339
Mailing address
4808 TEODOCIO ST NW, ALBUQUERQUE, NM 87107-3359
(505) 573-2339

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0188201
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15883086
NM
Enumeration date
11/20/2017
Last updated
06/16/2018
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