Individual
MS. DIANA L JAMISON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
25 OFFICE PARK DR, SUITE 2, KILMARNOCK, VA 22482
(804) 436-9218
(804) 435-6836
Mailing address
PO BOX 877, KILMARNOCK, VA 22482-0877
(804) 436-9218
(804) 435-6836
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904000993
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083330
OPTIMA HEALTH / SENTARA/
VA
01
—
186767
ANTHEM PROVIDER NUMBER
VA
Enumeration date
06/15/2006
Last updated
07/09/2007
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