Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813000426 | VA |
NPI | 1053836528 |
---|---|
Provider Name | Mrs. Cara Jean Jean O'neal |
First Address | Glen Allen, VA 23060-2232 |
Second Address | Glen Allen, VA 23060-2232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2017 |
Last Update Date | 07/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0813000426 | COMMONWEALTH OF VIRGINIA BOARD OF PSYCHOLOGY (01) | VA |