Individual
KIMBERLY NICOLE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 EVERGREEN AVE APT 5F, HAMDEN, CT 06518-2722
(914) 830-1592
Mailing address
200 EVERGREEN AVE APT 5F, HAMDEN, CT 06518-2722
(914) 830-1592
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
289218748
NY
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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