Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0810000289 | VA |
Y | 103G00000X | Clinical Psychologist | 0810000289 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810000289 | VA |
N | 103TF0200X | Forensic Psychologist | 0810000289 | VA |
NPI | 1215297395 |
---|---|
Provider Name | Dr. Meredith Krause |
First Address | Stafford, VA 22554-1545 |
Second Address | Stafford, VA 22554-1545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 22/10/2012 |