Individual
MR. ETHAN KYLE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
100 W JEFFERSON ST, CHARLOTTESVILLE, VA 22902-5023
(434) 201-2174
Mailing address
100 W JEFFERSON ST, CHARLOTTESVILLE, VA 22902-5023
(434) 201-2174
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
VA
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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