Provider Demographics
NPI:1376838607
Name:CHEUNG, KIMBALLEE (BEHAVIOR ANALYST)
Entity Type:Individual
Prefix:MISS
First Name:KIMBALLEE
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:BEHAVIOR ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11305 NW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2746
Mailing Address - Country:US
Mailing Address - Phone:954-345-8483
Mailing Address - Fax:954-345-8483
Practice Address - Street 1:3691 NW 124TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2409
Practice Address - Country:US
Practice Address - Phone:954-345-8483
Practice Address - Fax:954-345-8483
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-09-5744103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst