Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 3049 | NE |
NPI | 1003002981 |
---|---|
Provider Name | Katherine Kimmerling |
First Address | Bellevue, NE 68005-4558 |
Second Address | Bellevue, NE 68005-4558 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2007 |
Last Update Date | 27/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
47037660631 | (05) | NE |