Individual
KRISTIN SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2004 BREMO RD STE 201, RICHMOND, VA 23226-2442
(804) 272-2000
Mailing address
3003 STONY LAKE DR APT 2B, RICHMOND, VA 23235-6814
(757) 771-9771
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010714
VA
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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