Healthcare Provider Details

I. General information

NPI: 1760506455
Provider Name (Legal Business Name): KIMBERLY ANN BEGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 US HWY 58
DUFFIELD VA
24244
US

IV. Provider business mailing address

PO BOX 9054
GRAY TN
37615-9054
US

V. Phone/Fax

Practice location:
  • Phone: 276-431-4370
  • Fax: 276-431-2863
Mailing address:
  • Phone: 423-467-3600
  • Fax: 423-467-3696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701008508
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: