Individual
KAYLA BREANNE BALENSIEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7414 WALTON LN, ANNANDALE, VA 22003-2555
(571) 410-4110
Mailing address
7414 WALTON LN, ANNANDALE, VA 22003-2555
(571) 410-4110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904013646
VA
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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