| Doctor Name: | MRS. KIM KAZANAS |
| NPI Number: | 1013136076 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC, NCC |
| License Number: | LC2180 |
| Business Practice Address: | 832 Dividing Rd Severna Park, MD - 211464323 |
| Business Phone Number: | 4106938342 |
| Business Fax Number: | 4105447368 |
| Mailing Address: | 832 Dividing Rd, SEVERNA PARK |
| State: | MD |
| Postal Code: | 211464323 |
| Phone Number: | 4106938342 |
| Fax Number: | 4105447368 |
| NPI Enumeration Date: | 04/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LC2180 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |