Doctor Name: | KIMBERLEE JOY MURPHY CLARK |
NPI Number: | 1316255292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 0701004902 |
Business Practice Address: | 25152 Elk Lick Rd Suite 220 South Riding, VA - 201524506 |
Business Phone Number: | 7036595091 |
Business Fax Number: | |
Mailing Address: | 25152 Elk Lick Rd, Suite 220 SOUTH RIDING |
State: | VA |
Postal Code: | 201524506 |
Phone Number: | 7036595091 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2010 |
NPI Last Update Date: | 06/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701004902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |