Organization
MY OWN SPACE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HANNAH A. D. KIMBROUGH LMSW (THERAPIST)
(770) 756-6030
Entity
Organization
Contact information
Practice address
10440 DEERWOOD RD, 1218, HOUSTON, TX 77042-1135
(770) 756-6030
Mailing address
10440 DEERWOOD RD, 1218, HOUSTON, TX 77042-1135
(770) 756-6030
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW005881
GA
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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