Provider Demographics
NPI:1992101018
Name:PLUMMER, KIMONE ANIEKA (MS)
Entity type:Individual
Prefix:
First Name:KIMONE
Middle Name:ANIEKA
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 TENBY CHASE DR
Mailing Address - Street 2:APT. S244
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-2519
Mailing Address - Country:US
Mailing Address - Phone:732-447-4981
Mailing Address - Fax:
Practice Address - Street 1:193 TENBY CHASE DR
Practice Address - Street 2:APT. S244
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2519
Practice Address - Country:US
Practice Address - Phone:732-447-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health