Doctor Name: | CAROL ANN KIMBALL |
NPI Number: | 1114127941 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C. S.W. |
License Number: | 004242 |
Business Practice Address: | 1604 Antelope Trl Harker Heights, TX - 765482188 |
Business Phone Number: | 2546983217 |
Business Fax Number: | |
Mailing Address: | 1604 Antelope Trl, HARKER HEIGHTS |
State: | TX |
Postal Code: | 765482188 |
Phone Number: | 2546983217 |
Fax Number: | |
NPI Enumeration Date: | 07/19/2007 |
NPI Last Update Date: | 07/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 004242 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |