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Individual
MRS. KIMBERLY CLARK-WASHINGTON
Active
Individual
MRS. KIMBERLY CLARK-WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED., L.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19913
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1788887
—
TX
05
—
178888702
—
TX
01
—
7254LC
BLUECROSS BLUESHIELD
TX
Enumeration date
05/02/2007
Last updated
05/21/2008
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