Provider Demographics
NPI:1669741856
Name:HAMBLETON, KYMBERLY (MSW, BCD, LCSW)
Entity type:Individual
Prefix:MS
First Name:KYMBERLY
Middle Name:
Last Name:HAMBLETON
Suffix:
Gender:F
Credentials:MSW, BCD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 PLEASANT VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4305
Mailing Address - Country:US
Mailing Address - Phone:814-943-8164
Mailing Address - Fax:814-940-6524
Practice Address - Street 1:2907 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4305
Practice Address - Country:US
Practice Address - Phone:814-943-8164
Practice Address - Fax:814-940-6524
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0129971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical