Dionysus, Kimberly E
Dionysus, Kimberly E is an individual health care provider with primary practice located at 2030 S National Ave Ste 105 , Springfield MO 65804-2238. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Dionysus, Kimberly E can be contacted via phone (417) 820-9590.Contact Information
Primary practice address
2030 S National Ave Ste 105
Springfield MO 65804-2238
Phone: (417) 820-9590
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 071009108 | Illinois |
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 2011037843 | Missouri |
Profile Details
| NPI number | 1164709747 |
|---|---|
| LBN Legal business name | Dionysus, Kimberly E |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2011 |
| Last updated | Jul 9th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164709747 | NPPES |
| Oklahoma | MEDICAID | 200437390A | |
| Oklahoma | MEDICAID | 1164709747 | |
| Oklahoma | MEDICAID | 200750120A |
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