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General NPI Number Information
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NPI Number | 1548944713
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Entity Type | Individual
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Provider Name | MISS KIMBERLY R. WILLIAMS-GROSS
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Gender | Female
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Dates
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Enumeration Date | 06/09/2023
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Last Update Date | 06/09/2023
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Provider Practice Location Address
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Address Line | 3261 OLD WASHINGTON RD STE 2020
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City | WALDORF
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State | MD
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Zip | 20602-3231
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Country | US
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Telephone | 301-200-2051
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Fax |
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Provider Business Mailing Address
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Address Line | 6150 3RD ST
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City | CHESAPEAKE BEACH
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State | MD
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Zip | 20732-4140
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Country | US
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Telephone | 410-855-2531
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 28261
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License Number State | MD
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