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General NPI Number Information
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NPI Number | 1023228012
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Entity Type | Individual
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Provider Name | KIMBERLY CATHERINE CERNANSKY L.I.S.W
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 2384 QUEENSBURY RD
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City | ALLIANCE
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State | OH
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Zip | 44601-8399
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Country | US
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Telephone | 330-829-1937
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Fax |
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Provider Business Mailing Address
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Address Line | 2384 QUEENSBURY RD
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City | ALLIANCE
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State | OH
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Zip | 44601-8399
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Country | US
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Telephone | 330-829-1937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S0029485
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License Number State | OH
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