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General NPI Number Information
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NPI Number | 1063582195
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL MEDICINE ASSOCIATES LLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 220 W LEOTA ST SUITE 200
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6293
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Country | US
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Telephone | 308-534-4872
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Fax |
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Provider Business Mailing Address
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Address Line | 220 W LEOTA ST STE 200
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6293
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Country | US
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Telephone | 308-534-4872
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Fax |
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Authorized Official
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Title or Position | OWNER CLINICAL PSYCHOLOGIST
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Name | DR. LLOYD LEE KIMZEY JR.
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Credential | PH.D.
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Telephone | 308-534-4872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 675
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 208
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License Number State | NE
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