Individual
KIMBERLY ANN BUCKHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
232 DAN MONT VIS, DANIELS, WV 25832-9244
(304) 573-7238
Mailing address
232 DAN MONT VIS, DANIELS, WV 25832-9244
(304) 573-7238
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/21/2024
Last updated
11/21/2024
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