Individual
ANN KILGORE DIEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
14801 CHESDIN GREEN WAY, CHESTERFIELD, VA 23838-3278
(714) 322-9761
Mailing address
14801 CHESDIN GREEN WAY, CHESTERFIELD, VA 23838-3278
(714) 322-9761
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001358
VA
106H00000X
Marriage & Family Therapist
MFC 34408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601048159
—
VA
Enumeration date
03/22/2011
Last updated
02/13/2017
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