Provider Demographics
NPI:1942327598
Name:TAYLOR, KIMBALI ANNE (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KIMBALI
Middle Name:ANNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LAKE HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-8467
Mailing Address - Country:US
Mailing Address - Phone:423-991-0494
Mailing Address - Fax:
Practice Address - Street 1:479 COTTER ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2337
Practice Address - Country:US
Practice Address - Phone:423-991-0494
Practice Address - Fax:706-937-5183
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005328101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional