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General NPI Number Information
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NPI Number | 1174345474
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Entity Type | Individual
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Provider Name | KIMBERLY J SOUTIEN LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 12360 SW 132ND CT STE 113
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City | MIAMI
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State | FL
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Zip | 33186-6461
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Country | US
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Telephone | 305-588-4143
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Fax |
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Provider Business Mailing Address
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Address Line | 9741 SW 152ND ST 413C
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 786-379-9602
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH24518
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License Number State | FL
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