Individual
JULIE BALDOCK TIMBERLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
21 WALNUT BLVD, SUITES 1-3, PETERSBURG, VA 23805-2109
(804) 767-3470
(804) 490-0150
Mailing address
21 WALNUT BLVD, SUITES 1-3, PETERSBURG, VA 23805-2109
(804) 767-3470
(804) 490-0150
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904006910
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904006910
LICENSED CLINICAL SOCIAL WORKER
VA
Enumeration date
07/30/2013
Last updated
07/30/2013
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