Individual
KIMBERLY GENE BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPC; MFT; QMHP
Contact information
Practice address
400 SHADOW LN STE 106, LAS VEGAS, NV 89106-4355
(702) 731-0909
Mailing address
8936 SPANISH RIDGE AVE, LAS VEGAS, NV 89148-1354
(702) 731-0909
(702) 826-4757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
394-L
NV
101YP2500X
Professional Counselor
CPC 0024
NV
106H00000X
Marriage & Family Therapist
Primary
01197
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699956706
—
NV
Enumeration date
11/16/2007
Last updated
11/08/2019
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