Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C007477 | NC |
NPI | 1003117011 |
---|---|
Provider Name | Miss Kimberly G. Kueny |
First Address | Raleigh, NC 27607-6840 |
Second Address | Raleigh, NC 27609-7335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2010 |
Last Update Date | 19/11/2011 |