Doctor Name: | DR. CHRISTY LEE KIMPO |
NPI Number: | 1699027573 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, LMHC |
License Number: | LH 60104057 |
Business Practice Address: | 17808 2nd Ave Sw Normandy Park, WA - 981663706 |
Business Phone Number: | 2069482333 |
Business Fax Number: | |
Mailing Address: | 17808 2nd Ave Sw, NORMANDY PARK |
State: | WA |
Postal Code: | 981663706 |
Phone Number: | 2069482333 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2012 |
NPI Last Update Date: | 06/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH 60104057 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |