Individual
MISS KIMBERLY SHANTIA LONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
903 W 34TH ST, WILMINGTON, DE 19802-2527
(609) 649-6190
Mailing address
903 W 34TH ST, WILMINGTON, DE 19802-2527
(609) 649-6190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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