Provider Demographics
NPI:1447690508
Name:BARBER FOSS, KIM DANEEN (MS ATC)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:DANEEN
Last Name:BARBER FOSS
Suffix:
Gender:F
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6117 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-2437
Mailing Address - Country:US
Mailing Address - Phone:404-544-1306
Mailing Address - Fax:
Practice Address - Street 1:4450 FALCON PKWY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-3176
Practice Address - Country:US
Practice Address - Phone:404-544-1306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0040662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer