Provider Demographics
NPI:1497090880
Name:FLATT, KIMBERLEE K (MA, LPC, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:K
Last Name:FLATT
Suffix:
Gender:F
Credentials:MA, LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10190 NATURAL SETTINGS TRL
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:TX
Mailing Address - Zip Code:75407-4484
Mailing Address - Country:US
Mailing Address - Phone:469-396-4314
Mailing Address - Fax:
Practice Address - Street 1:10190 NATURAL SETTINGS TRL
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407-4484
Practice Address - Country:US
Practice Address - Phone:469-396-4314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68280101YP2500X
TX1-12-10316103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst