Individual
KELLI KOECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31 STAFFORD AVE, STAFFORD, VA 22554-7246
(540) 658-6000
Mailing address
21 NEVILLE CT, STAFFORD, VA 22554-8811
(814) 631-0593
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
0608562
VA
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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