Provider Demographics
NPI:1760152284
Name:ZIMMERMAN, RACHAEL
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 VOLVO PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3341
Mailing Address - Country:US
Mailing Address - Phone:757-606-0531
Mailing Address - Fax:866-266-0815
Practice Address - Street 1:1100 VOLVO PKWY STE 320
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3341
Practice Address - Country:US
Practice Address - Phone:757-606-0531
Practice Address - Fax:866-266-0815
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYSPCFY-1245235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist