Individual
KRISTINE L PANTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
13655 DULLES TECHNOLOGY DR STE 120, HERNDON, VA 20171-4634
(571) 665-4025
Mailing address
12705 FIRENZE CT, HERNDON, VA 20171-2715
(502) 592-8957
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904013748
VA
Other
Enumeration date
09/06/2022
Last updated
07/11/2024
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