Provider Demographics
NPI:1295869691
Name:COMERFORD, KIMBERLEE F
Entity type:Individual
Prefix:MS
First Name:KIMBERLEE
Middle Name:F
Last Name:COMERFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KIMBERLEE
Other - Middle Name:
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 MICHAELSON DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1355
Mailing Address - Country:US
Mailing Address - Phone:856-273-3247
Mailing Address - Fax:
Practice Address - Street 1:566 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1444
Practice Address - Country:US
Practice Address - Phone:856-858-9314
Practice Address - Fax:856-858-5672
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC117300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker