Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813001070 | VA |
NPI | 1073141636 |
---|---|
Provider Name | Jennifer Kay Dutcher Maurer |
First Address | Smithfield, VA 23430-6956 |
Second Address | Chesapeake, VA 23324-3527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2020 |
Last Update Date | 30/03/2020 |