Doctor Name: | KIMBERLY DAWN JOHNSON |
NPI Number: | 1376774216 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.A.C. |
License Number: | A1104045 |
Business Practice Address: | 2526 Highway 65 S Suite 202 Clinton, AR - 720316657 |
Business Phone Number: | 8665331765 |
Business Fax Number: | 8665331765 |
Mailing Address: | Po Box 558, CLINTON |
State: | AR |
Postal Code: | 720310558 |
Phone Number: | 8665331765 |
Fax Number: | 5017455921 |
NPI Enumeration Date: | 07/27/2009 |
NPI Last Update Date: | 11/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | A1104045 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |