Provider Demographics
NPI:1205195963
Name:ZIMMERMAN, EDITH LILA
Entity type:Individual
Prefix:MS
First Name:EDITH
Middle Name:LILA
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 1:5231 PENN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1768
Mailing Address - Country:US
Mailing Address - Phone:412-297-3336
Mailing Address - Fax:
Practice Address - Street 1:5231 PENN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1768
Practice Address - Country:US
Practice Address - Phone:412-297-3336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health