Individual
KIMBERLY N VAN ETTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
170 W MAIN ST STE B6, PURCELLVILLE, VA 20132-5829
(678) 520-0327
Mailing address
PO BOX 223, PURCELLVILLE, VA 20134-0223
(678) 520-0327
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010657
VA
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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