Individual
KATHERINE HEEKS POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1420 3RD ST SW, ROANOKE, VA 24016-5205
(540) 613-7047
Mailing address
2105 PLUM ST, SALEM, VA 24153-6207
(540) 986-5043
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009659
VA
1041C0700X
Clinical Social Worker
C006039
NC
Other
Enumeration date
07/28/2008
Last updated
06/21/2021
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