Individual
KIMBERLY WORMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
245 HAIRSTON ST, DANVILLE, VA 24540-4137
(434) 793-4931
(434) 799-3100
Mailing address
245 HAIRSTON ST, DANVILLE, VA 24540-4137
(434) 793-4931
(434) 799-3100
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003094
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945085
—
VA
Enumeration date
03/23/2006
Last updated
07/01/2010
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