Provider Demographics
NPI:1710389077
Name:ZIMMERMAN, BRITTNI (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 68TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61473-9395
Mailing Address - Country:US
Mailing Address - Phone:309-774-4253
Mailing Address - Fax:
Practice Address - Street 1:271 68TH ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:IL
Practice Address - Zip Code:61473-9395
Practice Address - Country:US
Practice Address - Phone:309-774-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004957235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist