Individual
KAITLYN ABIGAIL ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW-SUPERVISEE
Contact information
Practice address
12923 ERLENE DR, CHESTER, VA 23831-4508
(254) 702-1200
Mailing address
12923 ERLENE DR, CHESTER, VA 23831-4508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0906013648
VA
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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