Individual
KIMBERLY D THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1887 RICHMOND AVE, STATEN ISLAND, NY 10314-3939
(718) 698-1300
Mailing address
9520 222ND ST APT 5G, QUEENS VILLAGE, NY 11429-1304
(347) 886-5035
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-93279
NY
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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