Individual
MS. KATHERINE TERESA KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11835 HAZEL CIRCLE DR, BRISTOW, VA 20136-2180
(703) 396-7076
(703) 361-4335
Mailing address
13525 LELAND RD, CENTREVILLE, VA 20120-2037
(703) 222-3558
(703) 803-7130
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005806
VA
Other
Enumeration date
03/18/2008
Last updated
02/28/2013
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