Provider Demographics
NPI:1790925998
Name:DR. KIMBERLY A FINCH, INC
Entity Type:Organization
Organization Name:DR. KIMBERLY A FINCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:651-636-0099
Mailing Address - Street 1:2233 HAMLINE AVE N
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55113-5009
Mailing Address - Country:US
Mailing Address - Phone:651-636-0099
Mailing Address - Fax:651-636-1075
Practice Address - Street 1:2233 HAMLINE AVE N
Practice Address - Street 2:SUITE 217
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55113-5009
Practice Address - Country:US
Practice Address - Phone:651-636-0099
Practice Address - Fax:651-636-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN 4500251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1225048242OtherPERSONAL NPI
MN504122800Medicaid