Provider Demographics
NPI:1235355991
Name:PATRIZIA, KATHRYN FORD (MSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:FORD
Last Name:PATRIZIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S FAIRFAX ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3301
Mailing Address - Country:US
Mailing Address - Phone:704-684-7882
Mailing Address - Fax:
Practice Address - Street 1:109 S FAIRFAX ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3301
Practice Address - Country:US
Practice Address - Phone:704-684-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALC0904-0028081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical