Individual
KRISTIE L BUBKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
102 KEMP ST, LEBANON, VA 24266
(276) 889-3063
(276) 889-5025
Mailing address
PO BOX 810, CEDAR BLUFF, VA 24609
(276) 964-6702
(276) 964-5669
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002728
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945522
—
VA
01
—
216337
ANTHEM
VA
Enumeration date
07/02/2006
Last updated
07/08/2007
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