Basic Information
Provider Information
NPI: 1609018787
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOEHNE
FirstName: KIMBERLY
MiddleName: GARVEY
NamePrefix: MRS.
NameSuffix:  
Credential: M.A., BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1161 LAKE COOK RD
Address2:  
City: DEERFIELD
State: IL
PostalCode: 600155649
CountryCode: US
TelephoneNumber: 8474985437
FaxNumber: 8474985438
Practice Location
Address1: 1161 LAKE COOK RD
Address2:  
City: DEERFIELD
State: IL
PostalCode: 600155649
CountryCode: US
TelephoneNumber: 8474985437
FaxNumber: 8474985438
Other Information
ProviderEnumerationDate: 04/03/2009
LastUpdateDate: 05/13/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-06-3126ILY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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