Provider Demographics
NPI:1083791321
Name:ESAU, KIMBERLY SUE (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUE
Last Name:ESAU
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 GOLDEN VALLEY RD STE 230
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4682
Mailing Address - Country:US
Mailing Address - Phone:763-525-8590
Mailing Address - Fax:763-525-8590
Practice Address - Street 1:7575 GOLDEN VALLEY RD STE 230
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427
Practice Address - Country:US
Practice Address - Phone:763-525-8590
Practice Address - Fax:763-525-8590
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist