Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810003817 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810003817 | VA |
NPI | 1003181793 |
---|---|
Provider Name | Dr. Sarah Hastings |
First Address | Radford, VA 24141-1405 |
Second Address | Radford, VA 24141-1405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2012 |
Last Update Date | 14/03/2012 |