Individual
MRS. CHARLOTTA P ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 E SCHOOL ST, BONNE TERRE, MO 63628-1724
(636) 232-5894
(314) 845-3901
Mailing address
136 E SCHOOL ST, BONNE TERRE, MO 63628-1724
(636) 232-5894
(314) 845-3901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-30663
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992256945
—
MO
Enumeration date
03/22/2017
Last updated
03/22/2017
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