Provider Demographics
NPI:1275865073
Name:KMR THERAPY, LLC
Entity Type:Organization
Organization Name:KMR THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:COLEMAN PRIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-957-7348
Mailing Address - Street 1:5052 BALSAM DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5627
Mailing Address - Country:US
Mailing Address - Phone:813-957-7348
Mailing Address - Fax:
Practice Address - Street 1:5052 BALSAM DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5627
Practice Address - Country:US
Practice Address - Phone:813-957-7348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 7661251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health