Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810004723 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810004723 | VA |
N | 103G00000X | Clinical Psychologist | 3356 | NC |
N | 103TC0700X | Clinical Psychologist | 3356 | NC |
NPI | 1003951765 |
---|---|
Provider Name | Dr. Stephan Raab Weinland |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23298-5051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 16/05/2013 |