Individual
KENNETH PANKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A QMHP-A
Contact information
Practice address
2819 N PARHAM RD STE 260, HENRICO, VA 23294-4425
(804) 219-9554
Mailing address
6324 MANASSAS DR, CHESTERFIELD, VA 23832-7884
(804) 219-9554
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3485
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3485
—
VA
Enumeration date
06/13/2018
Last updated
07/03/2021
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