Individual
JONAH KANE-WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
6200 LAKESIDE AVE, HENRICO, VA 23228-5248
(804) 307-2801
Mailing address
800 PEPPER AVE, RICHMOND, VA 23226-2707
(434) 284-2084
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704015195
VA
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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