Provider Demographics
NPI:1033768114
Name:HOWELL, KIMBERLY KATHLEEN (COTA, MA, LMT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KATHLEEN
Last Name:HOWELL
Suffix:
Gender:F
Credentials:COTA, MA, LMT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:KATHLEEN
Other - Last Name:DOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMT
Mailing Address - Street 1:21600 OXNARD ST STE 1800
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-7807
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:
Practice Address - Street 1:5402 HOLLY RD STE 2102
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4673
Practice Address - Country:US
Practice Address - Phone:361-400-0277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician