Provider Demographics
NPI:1669626925
Name:ZIEMBA, SCOTT J (LMFT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:ZIEMBA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2244
Mailing Address - Country:US
Mailing Address - Phone:970-641-0229
Mailing Address - Fax:970-641-2949
Practice Address - Street 1:710 N TAYLOR ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2244
Practice Address - Country:US
Practice Address - Phone:970-641-0229
Practice Address - Fax:970-641-2949
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0144061106H00000X
CO1052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist