Organization
KINGA GUDOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINGA GUDOR LCSW, PHD (OWNER)
(757) 319-5416
Entity
Organization
Contact information
Practice address
129 W VIRGINIA BEACH BLVD STE 204A, NORFOLK, VA 23510-2030
(757) 319-5416
(757) 918-8760
Mailing address
1146 ROCKBRIDGE AVE, NORFOLK, VA 23508-1418
(757) 319-5416
(757) 918-8760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904007315
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508187881
—
VA
Enumeration date
01/11/2016
Last updated
01/11/2016
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