Individual
JACOB A ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1755 N WESTGATE DR STE 260, BOISE, ID 83704-7176
(208) 373-0790
(208) 373-0816
Mailing address
1755 N WESTGATE DR STE 260, BOISE, ID 83704-7176
(208) 373-0790
(208) 373-0816
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP6892
MN
103TC0700X
Clinical Psychologist
Primary
PSY203864
ID
Other
Enumeration date
02/06/2023
Last updated
08/14/2024
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