Organization
KYM KIDS PROFESSIONAL SERVICES, INC
Active
Other names
KYM Kids Professional Services, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMARA K YOUNG-MURRAY MSED (SPECIAL EDUCATION TEACHER)
(570) 242-9877
Entity
Organization
Contact information
Practice address
3625 ROCK SPRING LN, TOBYHANNA, PA 18466-8172
(570) 242-9877
Mailing address
3625 ROCK SPRING LN, TOBYHANNA, PA 18466-8172
(570) 242-9877
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
104415
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MEDICAID
—
NY
Enumeration date
04/23/2017
Last updated
04/23/2017
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