Individual
KIM MONTARULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
222 W 19TH ST, NORFOLK, VA 23517-2218
(757) 622-7017
Mailing address
150 BOUSH ST, NORFOLK, VA 23510-1626
(202) 674-1269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904013340
LICENSE
VA
Enumeration date
10/06/2021
Last updated
10/06/2021
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