Provider Demographics
NPI:1386135408
Name:SLOMAN, KIMBERLY (BCBA-D)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SLOMAN
Suffix:
Gender:F
Credentials:BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W. UNIVERSITY BLVD.
Mailing Address - Street 2:THE SCOTT CENTER
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901
Mailing Address - Country:US
Mailing Address - Phone:321-674-8106
Mailing Address - Fax:321-674-8411
Practice Address - Street 1:150 W. UNIVERSITY BLVD.
Practice Address - Street 2:THE SCOTT CENTER
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:321-674-8106
Practice Address - Fax:321-674-8411
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-05-2553103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1-05-2553OtherBCBA-D CERTIFICATION