Provider Demographics
NPI:1033210422
Name:MURRAY, KIMBERLY MICHELE (LISW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:MICHELE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 WINTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-1878
Mailing Address - Country:US
Mailing Address - Phone:440-801-1035
Mailing Address - Fax:
Practice Address - Street 1:3912 WINTON PARK DR
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-1878
Practice Address - Country:US
Practice Address - Phone:440-801-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0009828104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker