Individual
KIMBERLEE LOCKWOOD CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 726-9460
Mailing address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11700
SC
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
06/03/2016
Last updated
06/16/2020
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