Provider Demographics
NPI:1841637238
Name:SAULS, KIMBERLY DUARTE (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DUARTE
Last Name:SAULS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 SEA PALM DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3635
Mailing Address - Country:US
Mailing Address - Phone:915-241-0175
Mailing Address - Fax:
Practice Address - Street 1:2132 SEA PALM DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-3635
Practice Address - Country:US
Practice Address - Phone:915-241-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX536611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical