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General NPI Number Information
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NPI Number | 1639963580
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Entity Type | Organization
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Legal Business Name | KIMBERLY CAUDELL, PLLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 330 N EISENHOWER DR APT SUITE
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City | BECKLEY
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State | WV
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Zip | 25801-4122
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Country | US
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Telephone | 304-660-8292
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Fax | 304-929-2278
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Provider Business Mailing Address
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Address Line | 500 MOUNTAIN DR
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City | PEARISBURG
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State | VA
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Zip | 24134-1111
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Country | US
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Telephone | 304-660-8292
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Fax | 304-929-0786
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MRS. KIMBERLY DAWN CAUDELL
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Credential | MA
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Telephone | 304-660-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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