| NPI | 1780793695 |
|---|---|
| Former Name | ROSALYN FAYE ZIMMERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR C1625) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 570) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-12 |