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NPI Code Detail

MEDICARE: KIMBERLY PULLOM LSW

MEDICARE: KIMBERLY PULLOM LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerS.1502569OH

General Provider Information

NPI Number : 1407204977
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY PULLOM LSW
Provider Business Mailing Address
First Line : PO BOX 20068
Second Line :
City : TOLEDO
State : OH
Zip : 43610-0068
Country : US
Telephone Number : 419-531-5544
Fax Number :
Provider Business Practice Location Address
First Line : 5301 NEBRASKA AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43615-4632
Country : US
Telephone Number : 419-531-5544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2016
Last Update Date : 03/03/2026

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Directions to “ KIMBERLY PULLOM LSW” Practice Location

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