Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813000439 | VA |
NPI | 1083116313 |
---|---|
Provider Name | Mrs. Amber Berkley Thomas |
First Address | Newport News, VA 23602-8828 |
Second Address | Newport News, VA 23607-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 02/03/2018 |