Individual
AYANNA AKEYA KIMBREL ETHEREDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
166 PINEWOOD DR APT 3C, BATESBURG, SC 29006-2354
(803) 604-7783
Mailing address
166 PINEWOOD DR APT 3C, BATESBURG, SC 29006-2354
(803) 604-7783
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
SC
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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