Provider Demographics
NPI:1952733388
Name:ZIMMERMAN, JOANNA H (PHD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:H
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ELMAR DR SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5816
Mailing Address - Country:US
Mailing Address - Phone:703-539-2345
Mailing Address - Fax:
Practice Address - Street 1:344 MAPLE AVE W # 113
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5612
Practice Address - Country:US
Practice Address - Phone:703-539-2345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004606103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical