Individual
DEREK JOHN KIMMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 10TH AVE S STE 100, WAITE PARK, MN 56387-1400
(320) 200-1342
Mailing address
314 10TH AVE S STE 100, WAITE PARK, MN 56387-1400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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