Provider Demographics
NPI:1588704837
Name:ZIMMERMAN, LINDA J (PSY D)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 BROOKTREE RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9287
Mailing Address - Country:US
Mailing Address - Phone:724-935-9955
Mailing Address - Fax:724-935-9958
Practice Address - Street 1:8500 BROOKTREE RD
Practice Address - Street 2:SUITE 311
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9287
Practice Address - Country:US
Practice Address - Phone:724-935-9955
Practice Address - Fax:724-935-9958
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006527L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA204596OtherUPMC PROVIDER
PA193098OtherHIGHMARK PROVIDER
PA193098Medicare ID - Type Unspecified