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Individual

ILISSA GENEEN ZIMMERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
595 E EL PASO AVE APT 201, FRESNO, CA 93720-2808
(561) 951-3472
Mailing address
595 E EL PASO AVE APT 201, FRESNO, CA 93720-2808
(561) 951-3472

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15853
FL
224Z00000X
Occupational Therapy Assistant
3992
CA

Other

Enumeration date
09/14/2018
Last updated
09/14/2018
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