Individual
MS. KIM MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
865 LAUREL AVE, BRIDGEPORT, CT 06604-2406
(203) 854-6667
(203) 549-8683
Mailing address
865 LAUREL AVE, BRIDGEPORT, CT 06604-2406
(203) 854-6667
(203) 549-8683
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
# HCA.0000365
CT
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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