Individual
DR. KERRY LEDDY MALAWISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, PH.D.
Contact information
Practice address
6842 ELM ST, SUITE 104, MC LEAN, VA 22101-3891
(703) 734-1100
Mailing address
6842 ELM ST, SUITE 104, MC LEAN, VA 22101-3891
(703) 734-1100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001279
VA
1041C0700X
Clinical Social Worker
5259
MD
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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