Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 0701001720 | VA |
N | 101YP1600X | Pastoral Counselor |
NPI | 1265567093 |
---|---|
Provider Name | Kathryn Korbon |
First Address | Charlottesville, VA 22903-7653 |
Second Address | Charlottesville, VA 22903-7653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 09/07/2007 |