Individual
MARY S ZIMOMRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Contact information
Practice address
12007 SUNRISE VALLEY DR STE 300, RESTON, VA 20191-3446
(804) 207-6737
Mailing address
12007 SUNRISE VALLEY DR STE 300, RESTON, VA 20191-3446
(804) 207-6737
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701001964
VA
106H00000X
Marriage & Family Therapist
Primary
0717000883
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30015390670007
—
VA
Enumeration date
10/05/2006
Last updated
11/04/2024
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