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Organization

COLLIS KIMBROUGH, LCSW

Active
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Organization

COLLIS KIMBROUGH, LCSW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. COLLIS KIMBROUGH LCSW (SOLE PROPRIETOR/OWNER)
(954) 561-3112
Entity
Organization

Contact information

Practice address
2655 E OAKLAND PARK BLVD, SUITE 2, FORT LAUDERDALE, FL 33306-1662
(954) 561-3112
Mailing address
2655 E OAKLAND PARK BLVD, SUITE 2, FORT LAUDERDALE, FL 33306-1662
(954) 561-3112

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW9190
FL

Other

Enumeration date
04/18/2012
Last updated
04/18/2012
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