Basic Information
| Provider Information | |||||||||
| NPI: | 1730396748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIMBALL | ||||||||
| FirstName: | AIMEE | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3471 5TH AVE | ||||||||
| Address2: | SUITE 1010 KAUFMANN BLDG | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470943 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3471 5TH AVE | ||||||||
| Address2: | SUITE 1010 KAUFMANN BLDG | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470943 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TE1100X | Y | Behavioral Health & Social Service Providers | Psychologist | Exercise & Sports |
No ID Information.