Individual
JANE KIMIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
77 NEALY AVENUE, 633D MEDICAL, LANGLEY AIR FORCE BASE, VA 23665-2040
(757) 878-0807
Mailing address
77 NEALY AVENUE, 733D MEDICAL GROUP, LANGLEY AIR FORCE BASE, VA 23665
(757) 878-0807
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002069
VA
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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