Individual
MRS. KIMBERLY DEAN - COMMODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5645 LIBERTY FAIRFIELD RD, FAIRFIELD TOWNSHIP, OH 45011-2251
(513) 785-4245
Mailing address
PO BOX 1154, MIDDLETOWN, OH 45042-0854
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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