Individual
KIMBERLY SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1503 GREENWOOD AVE, LEHIGH ACRES, FL 33972-1627
(863) 234-1124
Mailing address
1503 GREENWOOD AVE, LEHIGH ACRES, FL 33972-1627
(863) 234-1124
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH 9022
FL
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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