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General NPI Number Information
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NPI Number | 1447016811
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Entity Type | Individual
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Provider Name | KIMBERLY DE'SHAUN WASHINGTON
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Gender | Female
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Dates
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Enumeration Date | 02/23/2024
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 334 LAKEVIEW DR
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City | ANGLETON
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State | TX
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Zip | 77515
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Country | US
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Telephone | 281-968-5868
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Fax |
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Provider Business Mailing Address
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Address Line | 23310 ZINFANDEL DR
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City | ALVIN
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State | TX
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Zip | 77511-2212
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Country | US
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Telephone | 601-334-1564
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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 | 94271
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License Number State | TX
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