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Individual

PRATHIMA KISHORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6677 RICHMOND HWY, ALEXANDRIA, VA 22306-6647
(703) 535-5568
(703) 535-1583
Mailing address
6677 RICHMOND HWY, ALEXANDRIA, VA 22306-6647
(703) 535-5568
(703) 535-1583

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710000580
VA

Other

Enumeration date
03/24/2015
Last updated
03/24/2015
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