Individual
KODY BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1135 HEATHERSTONE DR, FREDERICKSBURG, VA 22407-4828
(540) 699-0226
Mailing address
1135 HEATHERSTONE DR, FREDERICKSBURG, VA 22407-4828
(540) 699-0226
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701015693
VA
Other
Enumeration date
12/10/2025
Last updated
12/10/2025
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