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NPI Code Detail

MEDICARE: KIMBERLY BUTLER

MEDICARE:   KIMBERLY  BUTLER
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
1103K00000XBehavior Analyst
2106S00000XBehavior Technician
3106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1770259996
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY BUTLER
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-854-1116
Fax Number :
Provider Business Practice Location Address
First Line : 9440 MARLBORO PIKE
Second Line : SUITE 100
City : UPPER MARLBORO
State : MD
Zip : 20772-2077
Country : US
Telephone Number : 844-244-1818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2021
Last Update Date : 08/18/2021

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Directions to “ KIMBERLY BUTLER ” Practice Location

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