Individual
ALICE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
453 CARLISLE DR, SUITE 104, HERNDON, VA 20170-5611
(703) 939-1625
Mailing address
453 CARLISLE DR, SUITE 104, HERNDON, VA 20170-5611
(703) 939-1625
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006192
VA
Other
Enumeration date
08/09/2006
Last updated
04/16/2009
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