NPI Code Details Logo

NPI 1689503658

NPI 1689503658 : KIMBERLY ROSE RABON : GILBERT, SC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1689503658
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KIMBERLY ROSE RABON
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/15/2026
-----------------------------------------------------
    Last Update Date     |    05/15/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    108 INDIAN TRACE CT 
-----------------------------------------------------
    City                 |    GILBERT
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29054-8559
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    803-260-2648
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    108 INDIAN TRACE CT 
-----------------------------------------------------
    City                 |    GILBERT
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29054-8559
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    803-260-2648
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106S00000X
-----------------------------------------------------
    Taxonomy Name        |    Behavior Technician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    SC
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.