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Individual
MS. KIMBERLY SUE VANCE
Active
Individual
MS. KIMBERLY SUE VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTER OF EDUCATION
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
39001136A
IN
101YM0800X
Mental Health Counselor
Primary
39001136A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341223
ANTHEM
IN
05
—
200475040
—
IN
01
—
7381710
AETNA
IN
01
—
793356000
MAGELLAN
IN
Enumeration date
11/13/2006
Last updated
05/17/2024
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