Healthcare Provider Details

I. General information

NPI: 1578486866
Provider Name (Legal Business Name): TIOMBE BISA KENDRICK-DUNN EDD, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 W FLAGLER ST STE 900
MIAMI FL
33130-1807
US

IV. Provider business mailing address

PO BOX 695228
MIAMI FL
33269-2228
US

V. Phone/Fax

Practice location:
  • Phone: 561-719-5627
  • Fax:
Mailing address:
  • Phone: 561-719-5627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: