Individual
DR. KIMBERLY ELAINE KOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
502 N CARROLL AVE STE 120, SOUTHLAKE, TX 76092-6449
(682) 292-7012
Mailing address
1012 BROKEN WHEEL TRL, AUBREY, TX 76227-1284
(972) 971-9824
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34352
TX
103TS0200X
School Psychologist
33548
TX
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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