Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1053985663 |
---|---|
Provider Name | Katherine Kong |
First Address | Richmond, VA 23223-2458 |
Second Address | Richmond, VA 23223-2458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2021 |
Last Update Date | 18/05/2021 |