Provider Demographics
NPI:1750473641
Name:ZIMMERMAN, FRAN S (MA, LP)
Entity Type:Individual
Prefix:
First Name:FRAN
Middle Name:S
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8085 WAYZATA BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1453
Mailing Address - Country:US
Mailing Address - Phone:952-545-9310
Mailing Address - Fax:
Practice Address - Street 1:8085 WAYZATA BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1453
Practice Address - Country:US
Practice Address - Phone:952-545-9310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1584103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist