Provider Demographics
NPI:1326285677
Name:ZIMMERMAN, JULIE RENEE (MA, LPA)
Entity Type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:RENEE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 TATE BLVD SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-695-6500
Mailing Address - Fax:
Practice Address - Street 1:1985 TATE BLVD SE
Practice Address - Street 2:SUITE 300
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1433
Practice Address - Country:US
Practice Address - Phone:828-695-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2515103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical