Provider Demographics
NPI:1447790316
Name:ZIMMERMAN, JAY (MA, BCBA)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 WINTERBERRY CV
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1618
Mailing Address - Country:US
Mailing Address - Phone:901-283-6459
Mailing Address - Fax:
Practice Address - Street 1:8284 CLINTON WAY LN
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6305
Practice Address - Country:US
Practice Address - Phone:901-283-6459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst