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Provider Information for 1932677325


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KIMBERLY WASHINGTON LCSW


Sex: Female

NPI: 1932677325
Last Updated: 2018-11-30
Certification Date:

Details

NameValue
NPI1932677325
Enumeration Date2018-11-05
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 3560 ALMA RD APT 825
RICHARDSON, TX 75080-1104
United States

Phone: 219-614-2190 | Fax:
 
Primary Practice Address 4031 W PLANO PKWY STE 211
PLANO, TX 75093-5627
United States

Phone: 214-351-3490 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalTX66601