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Individual

KIMBERLY MARKETTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
655 7TH ST BLDG 700-A78, ROBINS AFB, GA 31098-2227
(478) 327-8421
Mailing address
655 7TH ST BLDG 700A78, ROBINS AFB, GA 31098-2227
(478) 327-8398

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW006255
GA
1041C0700X
Clinical Social Worker
C010480
NC
1041C0700X
Clinical Social Worker
CSW006255
GA

Other

Enumeration date
09/16/2014
Last updated
05/24/2022
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