Individual
KIMBERLY KOCAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
14277
SC
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/01/2018
Last updated
10/28/2021
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