Individual
KERRY ANN KRUK-BORISOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, ATR-BC, CSAC
Contact information
Practice address
2200 COLONIAL AVE STE 12, NORFOLK, VA 23517-1919
(757) 937-5780
Mailing address
3140 HERBERT ST, NORFOLK, VA 23513-2302
(757) 589-3498
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102187
VA
101YP2500X
Professional Counselor
Primary
0701005892
VA
221700000X
Art Therapist
0701005892
VA
Other
Enumeration date
07/14/2016
Last updated
10/19/2023
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