Provider Demographics
NPI:1316383623
Name:HALL, KIMBERLY FAITH (MA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:FAITH
Last Name:HALL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 MEMORIAL DR
Mailing Address - Street 2:STE. 203
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6326
Mailing Address - Country:US
Mailing Address - Phone:931-933-7200
Mailing Address - Fax:931-896-2075
Practice Address - Street 1:1820 MEMORIAL DR
Practice Address - Street 2:STE. 203
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6326
Practice Address - Country:US
Practice Address - Phone:931-933-7200
Practice Address - Fax:931-896-2075
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor