Individual
KIMBERLY E CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
308 E OAK AVE, TAMPA, FL 33602-2344
(813) 810-8110
Mailing address
22867 SOUTHSHORE DR, LAND O LAKES, FL 34639-4755
(813) 468-3505
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
PY7577
FL
103TC0700X
Clinical Psychologist
Primary
PY7577
FL
Other
Enumeration date
02/24/2009
Last updated
02/24/2009
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