Provider Demographics
NPI:1033675848
Name:ZIMMERMAN, VICTORIA HOPE (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:HOPE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 LOOKOUT PT APT 105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4708
Mailing Address - Country:US
Mailing Address - Phone:206-999-1605
Mailing Address - Fax:
Practice Address - Street 1:4811 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4694
Practice Address - Country:US
Practice Address - Phone:206-999-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health