Individual
KIMBERLY BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED
Contact information
Practice address
535 E 119TH ST, NEW YORK, NY 10035-4433
(917) 691-6222
Mailing address
535 E 119TH ST, NEW YORK, NY 10035-4433
(917) 691-6222
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/30/2020
Last updated
08/30/2020
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