Provider Demographics
NPI:1518464437
Name:KANE, IRENE
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13209 PARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4333
Mailing Address - Country:US
Mailing Address - Phone:703-925-8312
Mailing Address - Fax:703-925-8397
Practice Address - Street 1:13209 PARCHER AVE
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4333
Practice Address - Country:US
Practice Address - Phone:703-925-8312
Practice Address - Fax:703-915-8397
Is Sole Proprietor?:No
Enumeration Date:2018-04-08
Last Update Date:2018-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool