Provider Demographics
NPI:1942517040
Name:SAWYER, KIMBERLY DAWN (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DAWN
Last Name:SAWYER
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:OK
Mailing Address - Zip Code:73463-6391
Mailing Address - Country:US
Mailing Address - Phone:979-221-8217
Mailing Address - Fax:405-217-0866
Practice Address - Street 1:2770 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:OK
Practice Address - Zip Code:73463-6391
Practice Address - Country:US
Practice Address - Phone:979-221-8217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health