Zimomra, Mary S

Zimomra, Mary S is an sole proprietor health care provider with primary practice located at 12007 Sunrise Valley Dr Ste 300 , Reston VA 20191-3446. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Zimomra, Mary S can be contacted via phone (804) 207-6737.

Contact Information

Primary practice address
12007 Sunrise Valley Dr Ste 300 Reston VA 20191-3446
Phone: (804) 207-6737
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0717000883 Virginia
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701001964 Virginia

Profile Details

NPI number 1780770537
LBN Legal business name Zimomra, Mary S
Credentials LPC, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2006
Last updated Nov 29th, 2023 - about 2 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 1780770537 NPPES
Virginia MEDICAID 30015390670007

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