Provider Demographics
NPI:1528363223
Name:ZIMMERMAN, CATHERINE LOUISE (MSP, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LOUISE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 GAMEWELL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-3115
Mailing Address - Country:US
Mailing Address - Phone:803-727-5801
Mailing Address - Fax:
Practice Address - Street 1:1804 GAMEWELL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-3115
Practice Address - Country:US
Practice Address - Phone:803-727-5801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist