| Doctor Name: | MRS. KIMBERLY A BUSHANE |
| NPI Number: | 1396041794 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 72 069228 |
| Business Practice Address: | 341 W Main St Catskill, NY - 124141621 |
| Business Phone Number: | 5189432300 |
| Business Fax Number: | |
| Mailing Address: | 341 W Main St, CATSKILL |
| State: | NY |
| Postal Code: | 124141621 |
| Phone Number: | 5189432300 |
| Fax Number: | |
| NPI Enumeration Date: | 02/01/2011 |
| NPI Last Update Date: | 02/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | 72 069228 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |