Provider Information for 1063848786
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Mrs. KIMBERLY C SCALES LPC
Sex: Female
NPI: 1063848786
Last Updated: 2013-09-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1063848786 | ||||||||||||
| Enumeration Date | 2013-09-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 6320 BRENTWOOD STAIR RD FORT WORTH, TX 76112-3136 United States Phone: 817-548-9990 | Fax:817-446-9770 | ||||||||||||
| Primary Practice Address | 6320 BRENTWOOD STAIR RD FORT WORTH, TX 76112-3136 United States Phone: 817-548-9990 | Fax:817-446-9770 | ||||||||||||
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