| Doctor Name: | MS. KIMBERLY ANN STREET |
| NPI Number: | 1013046002 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC-MHSP |
| License Number: | 2134 |
| Business Practice Address: | 1440 Highway 70 E Dickson, TN - 370552220 |
| Business Phone Number: | 6157401114 |
| Business Fax Number: | 6157401114 |
| Mailing Address: | 1002 Williams Dr, WHITE BLUFF |
| State: | TN |
| Postal Code: | 371874900 |
| Phone Number: | 6157973882 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2134 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |