Provider Demographics
NPI:1053077545
Name:CARSWELL, KIMBERLY YVETTE
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:YVETTE
Last Name:CARSWELL
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 1:4203 28TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1728
Mailing Address - Country:US
Mailing Address - Phone:410-269-3931
Mailing Address - Fax:
Practice Address - Street 1:2900 NEWTON ST NE APT 507
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2960
Practice Address - Country:US
Practice Address - Phone:202-470-8438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist