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General NPI Number Information
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NPI Number | 1497144356
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Entity Type | Organization
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Legal Business Name | KIMBERLY CAPSTRAW, LMFT
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 115 E 4TH AVE STE 206
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City | MOUNT DORA
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State | FL
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Zip | 32757-5550
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Country | US
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Telephone | 407-227-9245
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Fax | 352-735-1551
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Provider Business Mailing Address
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Address Line | 27198 WOODHOLLOW RD
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City | MOUNT DORA
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State | FL
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Zip | 32757-9615
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Country | US
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Telephone | 407-227-9245
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Fax | 352-735-1551
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Authorized Official
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Title or Position | OWNER/ MARRIAGE AND FAMILY THERAPIS
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Name | MRS. KIMBERLY WESTBROOK CAPSTRAW
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Credential | LMFT
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Telephone | 407-227-9245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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