Provider Demographics
NPI:1902558679
Name:TURNBULL, KIMANI
Entity type:Individual
Prefix:
First Name:KIMANI
Middle Name:
Last Name:TURNBULL
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 1:714 PLATYPUS CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4323
Mailing Address - Country:US
Mailing Address - Phone:407-508-9012
Mailing Address - Fax:
Practice Address - Street 1:714 PLATYPUS CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4323
Practice Address - Country:US
Practice Address - Phone:407-508-9012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician