Individual
JORDAN LINDSEY KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S LABURNUM AVE, RICHMOND, VA 23223-5802
(804) 226-8745
Mailing address
3820 NINE MILE RD, RICHMOND, VA 23223-4831
(804) 652-3600
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-0608813
VA
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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