Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810003674 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810003674 | VA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 0810003674 | VA |
NPI | 1073611026 |
---|---|
Provider Name | Dr. D Giovanni Scott |
First Address | Baltimore, MD 21224-3737 |
Second Address | Norfolk, VA 23510-2015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 03/10/2013 |