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General NPI Number Information
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NPI Number | 1700744489
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Entity Type | Individual
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Provider Name | KIMBERLY SMITH
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 131 WRIGHT CIR
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City | NICEVILLE
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State | FL
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Zip | 32578-4231
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Country | US
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Telephone | 850-273-4706
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Fax | 239-402-9217
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Provider Business Mailing Address
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Address Line | 392 GLENDALE AVE
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City | VALPARAISO
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State | FL
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Zip | 32580-1088
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Country | US
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Telephone | 937-902-7995
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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-26-507425
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License Number State | FL
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