Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810004502 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810004502 | VA |
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1659632081 |
---|---|
Provider Name | Dr. Kathryn Pamela Wilder Schaaf |
First Address | Richmond, VA 23224-4915 |
Second Address | Richmond, VA 23224-4915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2012 |
Last Update Date | 06/09/2014 |