Provider Demographics
NPI:1679039812
Name:HINKSON-LEE, KIMBERLEY M
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:M
Last Name:HINKSON-LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 LEWIS HARGETT CIR # 201
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 LEWIS HARGETT CIR # 201
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3564
Practice Address - Country:US
Practice Address - Phone:859-475-4305
Practice Address - Fax:877-804-4492
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246700103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst