Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0904005434 | VA |
NPI | 1003104506 |
---|---|
Provider Name | Laura L Pasch |
First Address | Purcellville, VA 20132-3118 |
Second Address | Purcellville, VA 20132-3118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2011 |
Last Update Date | 18/07/2011 |