Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 08100001917 | VA |
Y | 103TC0700X | Clinical Psychologist | 08100001917 | VA |
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1568563161 |
---|---|
Provider Name | Dr. Evalyn G Bishop |
First Address | Charlottesville, VA 22901 |
Second Address | Charlottesville, VA 22911-8614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 18/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
087576 | OPTIMA HEALTH (01) | VA |
105614 | ANTHEM BCBS (01) | VA |
262463 | VALUE OPTIONS (01) | VA |
262463 | VALUE OPTIONS CH'VILLE (01) | VA |
88096M | OPTIMA HEALYH (01) | VA |
R51823 | (02) | VA |