Provider Demographics
NPI:1154480697
Name:GANHEWA, KATHRYN E
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:GANHEWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:E
Other - Last Name:GANHEWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:409 EAST MAIN ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141
Mailing Address - Country:US
Mailing Address - Phone:540-731-3603
Mailing Address - Fax:
Practice Address - Street 1:409 EAST MAIN ST.
Practice Address - Street 2:SUITE A
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141
Practice Address - Country:US
Practice Address - Phone:540-731-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor