Individual
KIMBERLY FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 SW MARLOW AVE STE 200, PORTLAND, OR 97225-5102
(510) 679-3545
Mailing address
3220 SE 92ND AVE APT 45, PORTLAND, OR 97266-1963
(206) 913-9692
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/21/2014
Last updated
09/14/2018
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