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Individual

KATHLEEN T. BAGBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4220 CYPRESS PARK DR, SUITE B, ROANOKE, VA 24018-8440
(540) 772-1872
(540) 772-4830
Mailing address
133 27TH ST SE, ROANOKE, VA 24014-3307
(540) 343-3389

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001807
VA

Other

Enumeration date
07/09/2006
Last updated
07/08/2007
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