Provider Demographics
NPI:1568510105
Name:KING, KIMBERLY JOINER (PHD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JOINER
Last Name:KING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:JOINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:331 MELROSE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4405
Mailing Address - Country:US
Mailing Address - Phone:972-231-2555
Mailing Address - Fax:
Practice Address - Street 1:331 MELROSE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4405
Practice Address - Country:US
Practice Address - Phone:972-231-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17884101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health