Doctor Name: | DR. KATHERINE GARDNER |
NPI Number: | 1760465462 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS LPC PSYD |
License Number: | 0701002587 |
Business Practice Address: | 289 Independence Blvd Pembroke 3 Ste 221 Virginia Beach, VA - 234625493 |
Business Phone Number: | 7574989320 |
Business Fax Number: | 7574989321 |
Mailing Address: | 289 Independence Blvd, Pembroke 3 Ste 221 VIRGINIA BEACH |
State: | VA |
Postal Code: | 234625493 |
Phone Number: | 7574989320 |
Fax Number: | 7574989321 |
NPI Enumeration Date: | 11/28/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0701002587 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |