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NPI Code Detail

MEDICARE: MRS. KIMBERLY MAE LUNNING M. ED. COUNSELING

MEDICARE: MRS. KIMBERLY MAE LUNNING M. ED. COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMC 60148468WA

General Provider Information

NPI Number : 1386053528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY MAE LUNNING M. ED. COUNSELING
Provider Business Mailing Address
First Line : PO BOX 3181
Second Line :
City : UNION GAP
State : WA
Zip : 98903-0181
Country : US
Telephone Number : 509-307-0354
Fax Number :
Provider Business Practice Location Address
First Line : 2815 RIVERSIDE RD
Second Line :
City : YAKIMA
State : WA
Zip : 98901-8538
Country : US
Telephone Number : 509-307-0354
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2014
Last Update Date : 08/12/2014

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