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Individual

KATHRYN JANE PERSONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
825 DILIGENCE DR STE 206, NEWPORT NEWS, VA 23606-4272
(757) 310-6900
(757) 240-5936
Mailing address
911 IRONWOOD DR, YORKTOWN, VA 23693-5563
(774) 788-1064

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008085
VA
1041C0700X
Clinical Social Worker
107865
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1898906
MA
01
P07340
BLUE CROSS
MA
Enumeration date
01/24/2007
Last updated
07/21/2022
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