Provider Demographics
NPI:1194429340
Name:ZIMMERMAN, JASON HARRY (NONE)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:HARRY
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7200 S ALTON WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2206
Mailing Address - Country:US
Mailing Address - Phone:303-945-7063
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:7200 S ALTON WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2206
Practice Address - Country:US
Practice Address - Phone:303-495-7063
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician