Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1063187045 |
---|---|
Provider Name | Mason Rhea Folk |
First Address | Rockingham, VA 22801-4924 |
Second Address | Harrisonburg, VA 22807-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2021 |
Last Update Date | 12/08/2021 |