Individual
KRISTEN MICHEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5937 COVE RD, ROANOKE, VA 24019-2403
(540) 562-3900
Mailing address
5937 COVE RD, ROANOKE, VA 24019-2403
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0803000235
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803000235
—
VA
Enumeration date
11/29/2017
Last updated
11/29/2017
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