Individual
KELSEY PAULINE STODTKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4850 MARK CENTER DR, ALEXANDRIA, VA 22311-1882
(703) 746-3394
Mailing address
1204 S WASHINGTON ST APT 131, ALEXANDRIA, VA 22314-4448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701008102
VA
101YP2500X
Professional Counselor
Primary
0701008102
VA
Other
Enumeration date
01/24/2019
Last updated
07/11/2024
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