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Individual

KIMBERLY ANNE WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3864 N 27TH AVE, PHOENIX, AZ 85017-4703
(602) 797-7000
Mailing address
15402 S 18TH DR, PHOENIX, AZ 85045-1833
(270) 804-8607

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-18251
AZ
101YM0800X
Mental Health Counselor
PROCOUPCC00211342
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100324490
KY
Enumeration date
10/13/2009
Last updated
12/05/2019
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