| Doctor Name: | KATHLEEN ANN FITZSIMMONS |
| NPI Number: | 1962679506 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD LPC |
| License Number: | 0701003741 |
| Business Practice Address: | 5506 Payne Dr King George, VA - 22485 |
| Business Phone Number: | 5406630574 |
| Business Fax Number: | 5406630576 |
| Mailing Address: | Po Box 149, DAHLGREN |
| State: | VA |
| Postal Code: | 224480149 |
| Phone Number: | 5406630574 |
| Fax Number: | 5406630576 |
| NPI Enumeration Date: | 05/13/2008 |
| NPI Last Update Date: | 05/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701003741 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |