Individual
J. KELLIE YOUNG EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,CSTOP
Contact information
Practice address
1805 AIRLINE BLVD, PORTSMOUTH, VA 23707-3912
(757) 397-2121
(757) 399-3316
Mailing address
1805 AIRLINE BLVD, PORTSMOUTH, VA 23707-3912
(757) 397-2121
(757) 399-3316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
VA
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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