| Organization Name: | KIMBERLEE DAUGHTRY LPC PLLC |
| NPI Number: | 1588928048 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLEE DAUGHTRY (LICENSED PROFESSIONAL COUNSELOR) |
| Mailing Address: | 4081 Dezavala Rd Suite 101 Shavano Park |
| State: | TX US |
| Postal Code: | 782492082 |
| Phone Number: | 2108652903 |
| Fax Number: | 2109577168 |
| NPI Enumeration Date: | 06/29/2012 |
| NPI Last Update Date: | 06/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 66779 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |