Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 102L00000X | Psychologist | IN | |
Y | 103T00000X | Psychologist | IN | |
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 170100000X | Medical Geneticist |
NPI | 1255649398 |
---|---|
Provider Name | Dr. Kimberly Carnegie Briscoe |
First Address | Crown Point, IN 46307-8681 |
Second Address | Crown Point, IN 46307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2010 |
Last Update Date | 23/09/2010 |