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General NPI Number Information
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NPI Number | 1346921558
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Entity Type | Individual
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Provider Name | MRS. KIMBERLY ANN CONKLIN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 140 MOUNTAIN AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3131
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Country | US
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Telephone | 732-397-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 89 NORMANDY RD
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City | COLONIA
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State | NJ
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Zip | 07067-1009
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Country | US
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Telephone | 732-397-0925
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-14-15098
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License Number State | NJ
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