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General NPI Number Information
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NPI Number | 1124775663
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Entity Type | Individual
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Provider Name | KATHERINE GAYNOR
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Gender | Female
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 1008 PENDLETON ST STE 1A
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2182
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Country | US
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Telephone | 703-596-9557
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Fax |
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Provider Business Mailing Address
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Address Line | 900 ARMY NAVY DR APT 1328
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City | ARLINGTON
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State | VA
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Zip | 22202-4931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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