Individual
KIMBERLY DAWN CLEMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1901 DUTTON DR, SUITE E, SAN MARCOS, TX 78666-7573
(512) 396-7695
(512) 396-7633
Mailing address
1901 DUTTON DR, SUITE E, SAN MARCOS, TX 78666-7573
(512) 396-7695
(512) 396-7633
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065337001
—
TX
Enumeration date
07/02/2013
Last updated
07/02/2013
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