Individual
MS. CAMILLE KIMMERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8626 LOWER SACRAMENTO RD, STOCKTON, CA 95210-1835
(209) 478-2487
Mailing address
9522 DURHAM CT, STOCKTON, CA 95209-4014
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/14/2011
Last updated
10/08/2014
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