Individual
CAPRICE V KIMBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 STONEWALL DR, INDIANOLA, MS 38751-2241
(662) 820-1262
Mailing address
116 STONEWALL DR, INDIANOLA, MS 38751-2241
(662) 820-1262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
11/30/2017
Last updated
11/30/2017
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