Individual
MIRIAM CARROLL CRUMBY KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SSP, NCSP
Contact information
Practice address
29816 ASTER ST, WALKER, LA 70785-7929
(318) 623-3863
Mailing address
29816 ASTER ST, WALKER, LA 70785-7929
(318) 623-3863
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
AN 478326
LA
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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