Provider Demographics
NPI:1235278995
Name:ROSA, KIMBERLEE CHRISTINA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:CHRISTINA
Last Name:ROSA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 E ACOMA DR
Mailing Address - Street 2:SUITE A203
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3553
Mailing Address - Country:US
Mailing Address - Phone:602-501-0678
Mailing Address - Fax:602-494-4454
Practice Address - Street 1:7010 E ACOMA DR
Practice Address - Street 2:SUITE A203
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3553
Practice Address - Country:US
Practice Address - Phone:602-501-0678
Practice Address - Fax:602-494-4454
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
AZLPC-1785101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist