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Individual

ANDREA KONIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
5875 BREMO RD, SUITE 104, RICHMOND, VA 23226-1934
(804) 287-7463
(804) 287-7722
Mailing address
5875 BREMO RD, SUITE 104, RICHMOND, VA 23226-1934
(804) 287-7463
(804) 287-7722

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004725
VA
390200000X
Student in an Organized Health Care Education/Training Program
NA
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C06778
GROUP PTAN
VA
Enumeration date
09/24/2009
Last updated
05/16/2016
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