| NPI | 1578233474 |
|---|---|
| Former Name | KIMBERLY ANN LIVELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH APS.005410) |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2025-06-20 |