Individual
KAITLYN HOLLEYANA WINGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1308 SHERWOOD AVE, RICHMOND, VA 23220-1210
(804) 628-2939
Mailing address
1308 SHERWOOD AVE, RICHMOND, VA 23220-1210
(804) 628-2939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010685
VA
Other
Enumeration date
09/05/2018
Last updated
02/21/2024
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