Provider Demographics
NPI:1508991738
Name:ZIMMERMAN, DEBORAH ANNE (MSPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5268 TALBOTS LNDG
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6800
Mailing Address - Country:US
Mailing Address - Phone:301-633-3087
Mailing Address - Fax:
Practice Address - Street 1:9256 BENDIX RD
Practice Address - Street 2:SUITE 105/106
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1840
Practice Address - Country:US
Practice Address - Phone:410-796-8499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD204322251P0200X
MD20423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics