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Provider Information for 1710984489


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KIMBERLY DURAN MA LMHC


Sex: Female

NPI: 1710984489
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1710984489
Enumeration Date2005-07-07
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 70 RADCLIFFE DR
PALM COAST, FL 32164-6876
United States

Phone: 386-586-7913 | Fax:
 
Primary Practice Address 1221 WILLIS AVE
DAYTONA BEACH, FL 32114-2809
United States

Phone: 386-236-1746 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH8267