Provider Demographics
NPI:1154685048
Name:SPEARS, KIMBERLY A (MS)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 CROSSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-1202
Mailing Address - Country:US
Mailing Address - Phone:405-348-8601
Mailing Address - Fax:
Practice Address - Street 1:1900 CROSSFIELD DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025-1202
Practice Address - Country:US
Practice Address - Phone:405-348-8601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional