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NPI Code Detail

MEDICARE: MRS. KIMBERLY WESTBROOK CAPSTRAW M.S.

MEDICARE:  MRS. KIMBERLY WESTBROOK CAPSTRAW  M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMT2411FL

General Provider Information

NPI Number : 1700181872
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY WESTBROOK CAPSTRAW M.S.
Provider Business Mailing Address
First Line : 27198 WOODHOLLOW RD
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-9615
Country : US
Telephone Number : 407-227-9245
Fax Number : 352-735-1551
Provider Business Practice Location Address
First Line : 115 E 4TH AVE STE 206
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-5550
Country : US
Telephone Number : 407-227-9245
Fax Number : 352-735-1551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2011
Last Update Date : 01/02/2015

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Directions to “ MRS. KIMBERLY WESTBROOK CAPSTRAW M.S.” Practice Location

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