Kimberly Mouton
Driver in Lawrenceville, GA. Individual provider (NPI-1).
NPI number1992268346
StatusActive
Last updated in NPPESApr 12, 2019
Details
- NPI
- 1992268346
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kimberly Mouton
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2019
- Last updated
- Apr 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172A00000X | Driver | – | – | Yes |
Practice location
1451 Green Oak CirLawrenceville, GA 30043-5449
Phone 770-377-9548
Mailing address
2133 Lawrenceville Suwanee Rd Ste 12Suwanee, GA 30024-2649
Phone 770-377-9548
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All 11 Driver providers in Lawrenceville · All 5,967 providers in Lawrenceville
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