| Doctor Name: | STEPHANIE ZIMMERMAN |
| NPI Number: | 1023148830 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 13714 |
| Business Practice Address: | 18322 Minnetonka Blvd Ste C Wayzata, MN - 553913258 |
| Business Phone Number: | 9524752818 |
| Business Fax Number: | 9524753356 |
| Mailing Address: | 18322 Minnetonka Blvd Ste C, WAYZATA |
| State: | MN |
| Postal Code: | 553913258 |
| Phone Number: | 9524752818 |
| Fax Number: | 9524753356 |
| NPI Enumeration Date: | 03/07/2007 |
| NPI Last Update Date: | 03/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 13714 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |