Zimmerly, Tina Rae

Zimmerly, Tina Rae is an individual health care provider with primary practice located at 8601 W Emerald St Ste 130 , Boise ID 83704-8209. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Zimmerly, Tina Rae can be contacted via phone (208) 600-2184.

Contact Information

Primary practice address
8601 W Emerald St Ste 130 Boise ID 83704-8209
Phone: (208) 600-2184
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1245856095
LBN Legal business name Zimmerly, Tina Rae
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2020
Last updated Feb 1st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245856095 NPPES
Idaho Other LMSW-40409 IDAHO BOARD OF SOCIAL WORK EXAMINERS

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