Provider Demographics
NPI:1891474656
Name:ZIMMERMANN, SARA ESTER (BS)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ESTER
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:ESTER
Other - Last Name:DEL REAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2528 RACING RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-6139
Mailing Address - Country:US
Mailing Address - Phone:856-803-4794
Mailing Address - Fax:
Practice Address - Street 1:2528 RACING RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-6139
Practice Address - Country:US
Practice Address - Phone:856-803-4794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-08-15
Deactivation Date:2023-07-18
Deactivation Code:
Reactivation Date:2023-08-15
Provider Licenses
StateLicense IDTaxonomies
SC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician