Organization
BODHI LEAF, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SASHI GABRIELLE KIMBALL LCSW (SOLE MEMBER)
(512) 653-4623
Entity
Organization
Contact information
Practice address
1300 WEST LYNN DRIVE, SUITE 207, AUSTIN, TX 78703
(512) 653-4623
Mailing address
204 E 34TH ST, APT B, AUSTIN, TX 78705-1665
(512) 653-4623
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
57473
TX
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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