Provider Demographics
NPI:1235632092
Name:TEMPLE, KIMBERLY FAITH (CFLE)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:FAITH
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 CARSKADDON AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1615
Mailing Address - Country:US
Mailing Address - Phone:419-901-1056
Mailing Address - Fax:
Practice Address - Street 1:3104 CARSKADDON AVE APT 304
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1615
Practice Address - Country:US
Practice Address - Phone:419-901-1056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator