Individual
KIMBA SAMBOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPA
Contact information
Practice address
3500 WESTGATE DR, SUITE 101, DURHAM, NC 27707-2567
(919) 402-8738
(919) 403-6106
Mailing address
3500 WESTGATE DR, SUITE 101, DURHAM, NC 27707-2567
(919) 402-8738
(919) 403-6106
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3557
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107722
—
NC
Enumeration date
09/30/2011
Last updated
01/19/2012
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