Provider Demographics
NPI:1467677369
Name:KRINSKY, KIM L (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:L
Last Name:KRINSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:KRINSKY
Other - Last Name:VALDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1696 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1600
Mailing Address - Country:US
Mailing Address - Phone:404-354-7335
Mailing Address - Fax:
Practice Address - Street 1:544 MEDLOCK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1515
Practice Address - Country:US
Practice Address - Phone:404-354-7335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical