Individual
BARBARA KIMBLE-GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 THOMASTON AVE, WATERBURY, CT 06702-1007
(203) 805-5300
Mailing address
703 MERIDEN WATERBURY TPKE, SOUTHINGTON, CT 06489-4154
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
003974
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003974
APRN LICENSE
CT
Enumeration date
07/20/2010
Last updated
07/20/2010
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