Provider Demographics
NPI:1174353635
Name:ZIMMERMANN, OLIVIA M (MA C-F SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:M
Last Name:ZIMMERMANN
Suffix:
Gender:F
Credentials:MA C-F SLP
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Mailing Address - Street 1:4450 N PROSPECT RD STE C5
Mailing Address - Street 2:
Mailing Address - City:PEORIA HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:61616-6578
Mailing Address - Country:US
Mailing Address - Phone:309-363-7594
Mailing Address - Fax:309-966-3621
Practice Address - Street 1:4450 N PROSPECT RD STE C5
Practice Address - Street 2:
Practice Address - City:PEORIA HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:61616-6578
Practice Address - Country:US
Practice Address - Phone:309-363-7594
Practice Address - Fax:309-966-3621
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL242.007834235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist