Individual
DR. KELLY RENEE ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AADCP-IP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
06/17/2013
Last updated
10/18/2023
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