Provider Demographics
NPI:1386053528
Name:LUNNING, KIMBERLY MAE (M ED COUNSELING)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MAE
Last Name:LUNNING
Suffix:
Gender:F
Credentials:M ED COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3181
Mailing Address - Street 2:
Mailing Address - City:UNION GAP
Mailing Address - State:WA
Mailing Address - Zip Code:98903-0181
Mailing Address - Country:US
Mailing Address - Phone:509-307-0354
Mailing Address - Fax:
Practice Address - Street 1:2815 RIVERSIDE RD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-8538
Practice Address - Country:US
Practice Address - Phone:509-307-0354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60148468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health