Individual
KIMBERLY DAWN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
804 INDUSTRIAL PARK RD, MAXWELTON, WV 24957-8066
(304) 497-0500
Mailing address
804 INDUSTRIAL PARK RD, MAXWELTON, WV 24957-8066
(304) 497-0500
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WV
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
10/02/2020
Last updated
06/04/2025
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