Individual
GRACE ELLEN KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
360 CAMPBELL AVE SW, ROANOKE, VA 24016-3625
(540) 563-5316
(540) 563-5254
Mailing address
360 CAMPBELL AVE SW, ROANOKE, VA 24016-3625
(540) 563-5316
(540) 563-5254
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006587
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904006587
LICENSE NUMBER
VA
Enumeration date
06/06/2007
Last updated
07/08/2007
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