Provider Demographics
NPI:1750887485
Name:WINSTEAD, KIMBERLY
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:WINSTEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 COUNTRYSIDE BLVD APT 90
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1315
Mailing Address - Country:US
Mailing Address - Phone:727-226-9373
Mailing Address - Fax:
Practice Address - Street 1:3455 COUNTRYSIDE BLVD
Practice Address - Street 2:90
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3376
Practice Address - Country:US
Practice Address - Phone:727-226-9373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician