Individual
KIMBERLY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43 ELIZABETH ST, PEMBERTON, NJ 08068-1232
(609) 316-0195
Mailing address
PO BOX 253, SKILLMAN, NJ 08558-0253
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-167928
NJ
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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