Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103G00000X | Clinical Psychologist | 0810003662 | VA |
N | 103TC0700X | Clinical Psychologist | 0810003662 | VA |
NPI | 1205892155 |
---|---|
Provider Name | Dr. Stephanie Adams Fearer |
First Address | Christiansburg, VA 24073-3866 |
Second Address | Salem, VA 24153-6404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/07/2007 |