Individual
MS. BONITA CROOM KIMBREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
120 GREENWELL DR, HAMPTON, VA 23666-1731
(757) 766-1711
Mailing address
120 GREENWELL DR, HAMPTON, VA 23666-1731
(757) 766-1711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004147
VA
1041S0200X
School Social Worker
PPS337705
VA
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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