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Individual

CATHERINE LEA KIMBALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LICSWA

Contact information

Practice address
105B W MAIN STE 113, PUYALLUP, WA 98371-5329
(253) 222-2988
Mailing address
PO BOX 1522, ORTING, WA 98360-1522
(253) 222-2988

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
SC60995790
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4CLF83
ICIS
OK
Enumeration date
07/19/2007
Last updated
03/31/2022
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