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Individual

MICHAEL KIMBALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
6635 W CENTRAL AVE, TOLEDO, OH 43617-1029
(734) 693-0554
(419) 517-1349
Mailing address
7040 MONROE ST, SYLVANIA, OH 43560-1923
(734) 454-3560
(734) 454-3570

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
07781
OH
103TC0700X
Clinical Psychologist
6301014600
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0294590
OH
Enumeration date
10/24/2013
Last updated
11/15/2024
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