Individual
KATELYN E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11835 HAZEL CIRCLE DR, BRISTOW, VA 20136-1223
(571) 416-0537
Mailing address
11835 HAZEL CIRCLE DR, BRISTOW, VA 20136-2180
(571) 416-0537
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701011080
VA
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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