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General NPI Number Information
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NPI Number | 1568271435
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Entity Type | Organization
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Legal Business Name | KIMBERLY LENNON, MARRIAGE AND FAMILY THERAPIST, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/04/2025
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Last Update Date | 01/04/2025
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Provider Practice Location Address
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Address Line | 1706 PLUM LN STE 114
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City | REDLANDS
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State | CA
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Zip | 92374-4578
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Country | US
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Telephone | 760-668-3921
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Fax |
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Provider Business Mailing Address
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Address Line | 356 CAMPBELL AVE
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City | REDLANDS
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State | CA
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Zip | 92373-6861
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY LENNON
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Credential |
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Telephone | 760-668-3921
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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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