Individual
MS. KIMBERLY BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
831 GROVE RD STE C, MIDLOTHIAN, VA 23114-2666
(804) 743-0960
Mailing address
831 GROVE RD STE C, MIDLOTHIAN, VA 23114-2666
(804) 743-0960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0904004211
VA
1041C0700X
Clinical Social Worker
Primary
0904004211
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008926565
—
VA
Enumeration date
07/19/2006
Last updated
09/18/2024
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