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Individual

DR. KATHERINE GARDNER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MS LPC PSYD

Contact information

Practice address
289 INDEPENDENCE BLVD, PEMBROKE 3 STE 221, VIRGINIA BEACH, VA 23462-5493
(757) 498-9320
(757) 498-9321
Mailing address
289 INDEPENDENCE BLVD, PEMBROKE 3 STE 221, VIRGINIA BEACH, VA 23462-5493
(757) 498-9320
(757) 498-9321

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701002587
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
081536
SENTARA
VA
01
148813
COMPSYCH
VA
01
154359
VALU OPTIONS
VA
01
190697
COMPSYCH
VA
01
2038918
CIGNA
VA
01
453371
ANTHEM
VA
01
466591
ANTHEM
VA
Enumeration date
11/28/2005
Last updated
07/08/2007
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