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NPI 1629557780

NPI 1629557780 : RENEE LYNN KIMBLE BA, LSW : CAMBRIDGE, OH

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General NPI Number Information
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    NPI Number           |    1629557780
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    Entity Type          |    Individual 
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    Provider Name        |    RENEE LYNN KIMBLE BA, LSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/09/2018
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    Last Update Date     |    01/15/2019
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Provider Practice Location Address
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    Address Line         |    2500 JOHN GLENN HWY 
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    City                 |    CAMBRIDGE
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    State                |    OH
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    Zip                  |    43725-9028
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    Country              |    US
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    Telephone            |    740-439-4428
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    Fax                  |    740-439-3389
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Provider Business Mailing Address
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    Address Line         |    2845 BELL ST 
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    City                 |    ZANESVILLE
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    State                |    OH
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    Zip                  |    43701-1720
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    Country              |    US
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    Telephone            |    740-454-9766
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    Fax                  |    740-588-6452
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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       |    S.1802701
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    License Number State |    OH
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