Individual
KIMBERLY NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1500 ROUTE 88, BRICK, NJ 08724-2320
(732) 785-1900
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
(732) 785-1900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05813800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
10/07/2019
Last updated
10/07/2019
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