Individual
KIMBERLY YOUNGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 JONES AND GIFFORD AVE, JAMESTOWN, NY 14701-2828
(716) 661-1408
(716) 661-1074
Mailing address
111 PARKVIEW AVE, JAMESTOWN, NY 14701-8333
(716) 969-9968
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008528
NY
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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