Most Relevant Information
Provider Data
| NPI Number: | 1003655796 |
| Provider Name: | KIMBERLY EARLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MT4871 |
Most Important Dates
| Enumeration Date: | 05/22/2024 |
| Last Updated: | 05/22/2024 |
Provider Practice Location
4610 17TH ST
SARASOTA
FL
342351843
Practice Location Phone/Fax
| Phone: | 9413718820 |
| Fax: |
Provider Mailing Location
11782 FOREST PARK CIR
BRADENTON
FL
342114984
Provider Mailing Phone/Fax
| Phone: | 9417303931 |
| Fax: |