Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 0810005485 | VA |
NPI | 1083288393 |
---|---|
Provider Name | Dr. Serena Chu |
First Address | Bethesda, MD 20892-9663 |
Second Address | Bethesda, MD 20892-2457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2021 |
Last Update Date | 13/11/2021 |