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NPI Code Detail

MEDICARE: MS. KIMBERLY MICHELLE DILLON LPC

MEDICARE: MS. KIMBERLY MICHELLE DILLON LPC
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
1101YP2500XProfessional Counselor17752TX

General Provider Information

NPI Number : 1871765602
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY MICHELLE DILLON LPC
Provider Business Mailing Address
First Line : 226 HIGH VIEW RANCH DR
Second Line :
City : CEDAR CREEK
State : TX
Zip : 78612-4813
Country : US
Telephone Number : 512-433-9712
Fax Number :
Provider Business Practice Location Address
First Line : 1524 S IH 35 STE 210
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2603
Country : US
Telephone Number : 512-343-8606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2008
Last Update Date : 04/01/2008

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