| NPI | 1700378015 |
|---|---|
| Former Name | KIMBERLY ANN MCCORMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist (Licence: AR 1164957080) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: AR 1164957080) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2024-08-02 |