Individual
KIM DERK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
10286 WEXFORD CT, NEWBURGH, IN 47630-8744
(812) 589-2908
Mailing address
4333 STATE ROUTE 261, NEWBURGH, IN 47630-2668
(812) 589-2908
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/24/2009
Last updated
01/24/2009
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