Individual
DR. KHILIA TYESE GIACOBONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC, CSOTP
Contact information
Practice address
PO BOX 337, MECHANICSVILLE, VA 23111-0337
(804) 306-1790
Mailing address
3315 CRAFTMASTER CT, MECHANICSVILLE, VA 23111-6144
(804) 306-1790
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701011919
VA
101YP2500X
Professional Counselor
PRC15359
DC
Other
Enumeration date
10/29/2024
Last updated
03/05/2026
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