Individual
MS. KRISTY BAZZANELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
315 JOHNNY HALL RD, MINERAL, VA 23117-5202
(540) 604-3267
(844) 480-1755
Mailing address
7036 ZACHARY TAYLOR HWY, MINERAL, VA 23117-5312
(540) 604-3267
(844) 480-1755
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006594
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601092978
—
VA
05
—
601101224
—
VA
Enumeration date
05/07/2016
Last updated
09/17/2016
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