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General NPI Number Information
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NPI Number | 1275040123
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Entity Type | Individual
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Provider Name | JOY KATHLEEN WIMBERLY
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Gender | Female
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Dates
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Enumeration Date | 01/01/2018
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Last Update Date | 01/01/2018
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Provider Practice Location Address
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Address Line | 3296 CAHABA HEIGHTS RD # 200
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City | VESTAVIA
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State | AL
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Zip | 35243-1653
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Country | US
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Telephone | 205-253-6903
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Fax |
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Provider Business Mailing Address
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Address Line | 3296 CAHABA HEIGHTS RD # 200
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City | VESTAVIA
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State | AL
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Zip | 35243-1653
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-17-3833
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License Number State | AL
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