Individual
KATY B PROFFITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
12020 SUNRISE VALLEY DR STE 100, RESTON, VA 20191-3429
(646) 941-7645
(929) 596-7897
Mailing address
2510 WISTAR ST, RICHMOND, VA 23294-3512
(804) 386-8650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904016816
VA
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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