Provider Demographics
NPI:1255657607
Name:HOUSTON, KIMBERLY ANN (LSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:BENNIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 KRESGE LN
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-6435
Mailing Address - Country:US
Mailing Address - Phone:775-359-9200
Mailing Address - Fax:775-359-9205
Practice Address - Street 1:350 KRESGE LN
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-6435
Practice Address - Country:US
Practice Address - Phone:775-359-9200
Practice Address - Fax:775-359-9205
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker