Provider Demographics
NPI:1285173468
Name:ZIMMER, ERIN RILEY (LLMFT)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:RILEY
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 W MICHIGAN ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2492
Mailing Address - Country:US
Mailing Address - Phone:989-317-4664
Mailing Address - Fax:
Practice Address - Street 1:304 W MICHIGAN ST
Practice Address - Street 2:SUITE 12
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2492
Practice Address - Country:US
Practice Address - Phone:989-317-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006722106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist