Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813001010 | VA |
NPI | 1003377318 |
---|---|
Provider Name | Kristen Leland |
First Address | Virginia Beach, VA 23452-7017 |
Second Address | Norfolk, VA 23510-2723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2019 |
Last Update Date | 28/03/2019 |