Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810000876 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810000876 | VA |
N | 103G00000X | Clinical Psychologist | 0810000876 | VA |
N | 103TC0700X | Clinical Psychologist | 0810000876 | VA |
NPI | 1003073875 |
---|---|
Provider Name | Dr. John Francis House |
First Address | Richmond, VA 23238-4476 |
Second Address | Richmond, VA 23238-4476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 20/05/2008 |