Individual
KIMBERLY JANE PEACOCK HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1721 DUCATUS DR, MIDLOTHIAN, VA 23113-4067
(804) 550-8414
Mailing address
1721 DUCATUS DR, MIDLOTHIAN, VA 23113-4067
(804) 550-8414
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004022
VA
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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