Provider Demographics
NPI:1649833138
Name:AUVIL, KIMBERLY (DAC, LAC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:AUVIL
Suffix:
Gender:F
Credentials:DAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6442
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-0442
Mailing Address - Country:US
Mailing Address - Phone:617-852-8910
Mailing Address - Fax:
Practice Address - Street 1:210 COUNTRY DAY RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2603
Practice Address - Country:US
Practice Address - Phone:617-852-8910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02604171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist