Individual
DR. MARILYN CECELIA KIMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1138 MELROSE DR, CLARKSTON, GA 30021-2837
(404) 508-2348
Mailing address
1138 MELROSE DR, CLARKSTON, GA 30021-2837
(404) 508-2348
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1456
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61-00158
EVERCARE CHOICE PROVIDER
GA
Enumeration date
08/08/2006
Last updated
07/08/2007
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