Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0904008884 | VA |
NPI | 1003203688 |
---|---|
Provider Name | Lisa Bessette |
First Address | Glen Allen, VA 23060-4419 |
Second Address | Glen Allen, VA 23060-4419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2015 |
Last Update Date | 04/11/2016 |