MRS. Kathleen Waggoner Petty, LCSW, CSAC

NPI #1811206204 in Lansdowne, Virginia

Provider Information

NPI Number
1811206204
Entity Type
Individual
Name
MRS. Kathleen Waggoner Petty, LCSW, CSAC
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Counselor - Mental Health
Credential
LCSW, CSAC
Enumeration Date
Oct 1, 2010
Last Updated
Oct 1, 2010

Practice Location

Address
19441 GOLF VISTA PLZ
Address 2
SUITE 110
ZIP Code
20176-8269
Phone
(703) 402-3080

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)
Counselor - Mental HealthMental Health

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