Provider Demographics
NPI:1063846178
Name:ZIMMERMAN, TRICIA LEIGH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:LEIGH
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:TRICIA
Other - Middle Name:LEIGH
Other - Last Name:BORRUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1035 S WEAVER DR
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-7018
Mailing Address - Country:US
Mailing Address - Phone:480-242-2631
Mailing Address - Fax:480-969-0792
Practice Address - Street 1:7575 E EARLL DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6915
Practice Address - Country:US
Practice Address - Phone:480-448-7665
Practice Address - Fax:480-448-7614
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC11592101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor