| NPI | 1710440805 |
|---|---|
| Other Name | KIMBERLY MATA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX 40350948) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2026-01-15 |