Provider Demographics
NPI:1518540160
Name:BARRON, KIMBERLY DAVIS (ALC)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DAVIS
Last Name:BARRON
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 S PAINTER AVE
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-0865
Mailing Address - Country:US
Mailing Address - Phone:334-443-0848
Mailing Address - Fax:833-974-3021
Practice Address - Street 1:299 S PAINTER AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-0865
Practice Address - Country:US
Practice Address - Phone:334-443-0848
Practice Address - Fax:833-974-3021
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health