Individual
ALYSSA KIMBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 WINANS AVE, HILLSIDE, NJ 07205-1448
(908) 868-7784
Mailing address
255 WINANS AVE, HILLSIDE, NJ 07205-1448
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06355600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SL06355600
LSW
—
Enumeration date
12/19/2019
Last updated
03/09/2023
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