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General NPI Number Information
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NPI Number | 1598112815
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Entity Type | Individual
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Provider Name | KIMBERLI BARNES
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Gender | Female
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 110 PATTON AVE
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City | HATTIESBURG
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State | MS
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Zip | 39401-6155
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Country | US
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Telephone | 601-582-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17374
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City | HATTIESBURG
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State | MS
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Zip | 39404-7374
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Country | US
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Telephone | 601-891-0128
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 3139
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0544
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License Number State | MS
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