Provider Demographics
NPI:1952023400
Name:ZIMMERMAN, JENDI MARIE
Entity Type:Individual
Prefix:
First Name:JENDI
Middle Name:MARIE
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 1:117 HILL ST
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15865-1005
Mailing Address - Country:US
Mailing Address - Phone:814-771-3702
Mailing Address - Fax:
Practice Address - Street 1:81 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-771-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist