Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810004838 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810004838 | VA |
NPI | 1003366436 |
---|---|
Provider Name | Caitriona Hayes |
First Address | Springfield, VA 22152-1849 |
Second Address | Springfield, VA 22152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2016 |
Last Update Date | 10/10/2016 |