Individual
KIM WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11017 179TH ST, JAMAICA, NY 11433-3505
(917) 546-6851
Mailing address
11017 179TH ST, JAMAICA, NY 11433-3505
(917) 546-6851
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
086453851
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086453851
SPECIAL EDUCATION
NY
Enumeration date
09/17/2015
Last updated
09/17/2015
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