Provider Demographics
NPI:1124635834
Name:ZIMMER, KIRA
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIRA
Other - Middle Name:
Other - Last Name:LAUVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 736706
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-6706
Mailing Address - Country:US
Mailing Address - Phone:317-502-3512
Mailing Address - Fax:855-915-0244
Practice Address - Street 1:5945 ROCKWELL DR NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7360
Practice Address - Country:US
Practice Address - Phone:319-382-9318
Practice Address - Fax:855-915-0244
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-26
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1-23-69381103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst