Individual
DR. KATHLEEN PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
700 24TH ST, FORT LEE, VA 23801-1716
(253) 278-2607
Mailing address
8024 FLAG TAIL DR, MIDLOTHIAN, VA 23112-1954
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
04939
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/28/2008
Last updated
06/22/2023
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