Provider Demographics
NPI:1639432636
Name:ALDOUS, KIMBERLY R (NTMB)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:R
Last Name:ALDOUS
Suffix:
Gender:F
Credentials:NTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 S MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-1812
Mailing Address - Country:US
Mailing Address - Phone:802-244-8877
Mailing Address - Fax:
Practice Address - Street 1:46 S MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1812
Practice Address - Country:US
Practice Address - Phone:802-244-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist