Individual
KIMBERLEY LYNNE SMITH DALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BC-DMT, CADC-R, LPC
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-9240
Mailing address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-9240
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C5011
OR
225600000X
Dance Therapist
001409
NY
225600000X
Dance Therapist
BC-DMT-1131
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5011
OREGON BOARD OF LICENSED PROFESSIONAL COUNSELORS AND THERAPISTS
OR
Enumeration date
07/22/2011
Last updated
03/29/2024
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