Provider Demographics
NPI:1063835247
Name:BRONNER, KIMBERLY ANNETTE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNETTE
Last Name:BRONNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 AUGUSTA CIR APT 117
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-5755
Mailing Address - Country:US
Mailing Address - Phone:845-629-8024
Mailing Address - Fax:
Practice Address - Street 1:8018 COCONUT STREET
Practice Address - Street 2:POSITIVE BEHAVIOR SUPPORTS CORP
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455
Practice Address - Country:US
Practice Address - Phone:772-349-6317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other