Individual
MS. KIM'E WOODS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
916 WATERMAN AVE, FRESNO, CA 93706-3762
(559) 321-1309
Mailing address
916 WATERMAN AVE, FRESNO, CA 93706-3762
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225539836
SUBSTANCE USE DISORDER
CA
Enumeration date
03/05/2018
Last updated
03/05/2018
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