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1730859539
KIMBERLY ELLEN BANACH
CHARLTON, MA
NPI
1730859539
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2021-09-14
Last Update Date
2021-09-14
Business Address
Ms. KIMBERLY ELLEN BANACH
75 BOND RD
CHARLTON, MA 01507-1301
Phone number: 508-523-8371
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Mailing Address
Ms. KIMBERLY ELLEN BANACH
75 BOND RD
CHARLTON, MA 01507-1301
Phone number: 774-200-3942
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