Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813000752 | VA |
NPI | 1033622576 |
---|---|
Provider Name | Hannah White |
First Address | Rocky Mount, VA 24151-8105 |
Second Address | Rocky Mount, VA 24151-6614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 07/11/2017 |