Provider Demographics
NPI:1427508118
Name:GOLUBOV, KIMBERLEY (RBT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLEY
Middle Name:
Last Name:GOLUBOV
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CARVER
Mailing Address - State:MA
Mailing Address - Zip Code:02330-1210
Mailing Address - Country:US
Mailing Address - Phone:508-209-7130
Mailing Address - Fax:
Practice Address - Street 1:1 HUCKLEBERRY LN
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1206
Practice Address - Country:US
Practice Address - Phone:508-843-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician