Individual
KIMBERLY WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5863 CABANNE AVE, SAINT LOUIS, MO 63112-2410
(314) 494-2924
Mailing address
5863 CABANNE AVE, SAINT LOUIS, MO 63112-2410
(314) 494-2924
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC1806297
STATE OF MISSOURI
MO
Enumeration date
11/11/2019
Last updated
08/17/2021
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