Provider Demographics
NPI:1962730408
Name:KHARE, KIMBERLY (MA, CMT, NRMT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:KHARE
Suffix:
Gender:F
Credentials:MA, CMT, NRMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WARREN AVE
Mailing Address - Street 2:COMMUNITY MUSIC CENTER OF BOSTON
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6104
Mailing Address - Country:US
Mailing Address - Phone:617-482-7494
Mailing Address - Fax:617-482-6267
Practice Address - Street 1:34 WARREN AVE
Practice Address - Street 2:COMMUNITY MUSIC CENTER OF BOSTON
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-6104
Practice Address - Country:US
Practice Address - Phone:617-482-7494
Practice Address - Fax:617-482-6267
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist