Individual
KIMBERLY WALLACE MASHEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW-S
Contact information
Practice address
24809 AL HWY 25, COLUMBIANA, AL 35051
(205) 602-4892
Mailing address
PO BOX 212, COLUMBIANA, AL 35051-0212
(205) 602-4892
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1611C
AL
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/07/2023
Last updated
08/01/2024
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