Provider Demographics
NPI:1780932780
Name:KIMBALL, ANN ELISABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:ELISABETH
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 TWIN KNOLLS RD
Mailing Address - Street 2:STE. 327
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3266
Mailing Address - Country:US
Mailing Address - Phone:410-992-9149
Mailing Address - Fax:
Practice Address - Street 1:5525 TWIN KNOLLS RD
Practice Address - Street 2:STE. 327
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3266
Practice Address - Country:US
Practice Address - Phone:410-992-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist