Otelus, Kim Nicole
Otelus, Kim Nicole is an sole proprietor health care provider with primary practice located at 3001 Heritage Villa Dr , Lithonia GA 30038-2478. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Otelus, Kim Nicole can be contacted via phone (678) 954-9649.Contact Information
Primary practice address
3001 Heritage Villa Dr
Lithonia GA 30038-2478
Phone: (678) 954-9649
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | Georgia |
Profile Details
| NPI number | 1306435763 |
|---|---|
| LBN Legal business name | Otelus, Kim Nicole |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 11th, 2021 |
| Last updated | Jan 11th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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