Individual
KIMBERLY DEANNA MCCLANNAHAN
Active
Individual
KIMBERLY DEANNA MCCLANNAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, ATR-BC, RPT-S,
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
RPT-S-S1805
—
101YP2500X
Professional Counselor
LPC0011396
CO
101YP2500X
Professional Counselor
Primary
LPC006713
GA
2080C0008X
Child Abuse Pediatrics Physician
—
—
221700000X
Art Therapist
12-136
—
Other
Enumeration date
05/08/2012
Last updated
01/03/2018
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