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General NPI Number Information
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NPI Number | 1669826004
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Entity Type | Individual
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Provider Name | KIMBERLY BUNCH-CRUMP PH.D., BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 8 PARK PL APT 347P
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City | HATTIESBURG
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State | MS
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Zip | 39402-1570
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Country | US
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Telephone | 704-277-5227
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Fax |
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Provider Business Mailing Address
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Address Line | 163 PAXTON LN
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City | EDENTON
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State | NC
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Zip | 27932-9629
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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