| Doctor Name: | KIMBERLY FARRIS |
| NPI Number: | 1083947964 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 33563 |
| Business Practice Address: | 400 Airport Rd Terrell, TX - 751604302 |
| Business Phone Number: | 9725244159 |
| Business Fax Number: | 9725635321 |
| Mailing Address: | 400 Airport Rd, TERRELL |
| State: | TX |
| Postal Code: | 751604302 |
| Phone Number: | 9725244159 |
| Fax Number: | 9725635321 |
| NPI Enumeration Date: | 09/10/2009 |
| NPI Last Update Date: | 09/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 33563 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |