Individual
KIMBERLY JO RAINES-KORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2009037938
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496536806
—
MO
Enumeration date
08/05/2011
Last updated
07/21/2022
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