Healthcare Provider Details

I. General information

NPI: 1225447337
Provider Name (Legal Business Name): DONNA KIMBROUGH MA,LPC,BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA ALMEIDA MA,LPC, BCBA

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 07/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 PREMIER DR 234
IRVING TX
75063-2661
US

IV. Provider business mailing address

133 GLENDALE DR
COPPELL TX
75019-5146
US

V. Phone/Fax

Practice location:
  • Phone: 817-249-4807
  • Fax: 817-249-2215
Mailing address:
  • Phone: 817-249-8100
  • Fax: 817-249-2215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13303
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number71195
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: