Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | VA |
NPI | 1053810515 |
---|---|
Provider Name | Catherine Lee |
First Address | Hampton, VA 23669-3568 |
Second Address | Hampton, VA 23669-3568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2018 |
Last Update Date | 09/02/2018 |