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Individual

KENDRA BURNSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2241 TACKETT'S MILL DRIVE, SUITE G, LAKE RIDGE, VA 22192
(703) 494-1434
Mailing address
2241 TACKETT'S MILL DRIVE, SUITE G, LAKE RIDGE, VA 22192
(703) 494-1534

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010222
VA
1041C0700X
Clinical Social Worker
3544
OK

Other

Enumeration date
09/12/2008
Last updated
04/09/2018
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