Individual
KRISTINE LEUVELINK GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
6829 ELM ST STE 300, MC LEAN, VA 22101-3845
(703) 532-4892
Mailing address
6829 ELM ST STE 300, MC LEAN, VA 22101-3845
(703) 532-4892
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0019002714
VA
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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