Individual
KIMBERLY DESHAY DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MBC
Contact information
Practice address
6430 COURT RD BLDG A, HOUSTON, TX 77053-4462
(325) 391-4168
Mailing address
4904 RIPPLE CREEK DR, BAYTOWN, TX 77521-1913
(832) 427-8425
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251B00000X
Case Management Agency
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
03/10/2022
Last updated
04/20/2024
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