Individual
MS. KIMBERLY ELLEN BANACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 BOND RD, CHARLTON, MA 01507-1301
(508) 523-8371
Mailing address
75 BOND RD, CHARLTON, MA 01507-1301
(774) 200-3942
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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