Individual
MRS. KIMBERLY DAWN NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10220 N 31ST AVE, #101, PHOENIX, AZ 85051
(602) 997-2233
(602) 997-2615
Mailing address
15338 W PORT AU PRINCE LANE, SURPRISE, AZ 85379
(623) 544-7640
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW10299
AZ
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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