Individual
KELLAN WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12020 SUNRISE VALLEY DR STE 100, RESTON, VA 20191-3429
(646) 941-7645
Mailing address
931 N AUGUSTA ST APT 3, STAUNTON, VA 24401-3293
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904014534
VA
Other
Enumeration date
11/11/2022
Last updated
12/07/2024
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