Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1184782153 |
---|---|
Provider Name | Mrs. Kimberly Sue Frantz |
First Address | Mexico Beach, FL 32410-3877 |
Second Address | Mexico Beach, FL 32456-0143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 09/07/2007 |