Provider Demographics
NPI:1831226018
Name:CROSBY, KIMBERLY A (PHD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:CROSBY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N TACOMA AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-2771
Mailing Address - Country:US
Mailing Address - Phone:806-535-5777
Mailing Address - Fax:
Practice Address - Street 1:406 N TACOMA AVE APT 2
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-2771
Practice Address - Country:US
Practice Address - Phone:806-535-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY271785103TC0700X
WAPY61267885103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical