Individual
MRS. KIMBERLY GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005317
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010122406
—
VA
Enumeration date
07/19/2006
Last updated
08/28/2024
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