| NPI | 1073772208 | 
|---|---|
| Former Name | KIMBERLY W COLLEY | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904006814)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000006886)  | 
| Enumeration Date | 2008-06-03 | 
| Last Update Date | 2019-08-19 |