| NPI | 1942603154 |
|---|---|
| Former Name | TINA TRAN KIMBROUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-18535) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-15245) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2022-06-22 |