Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813000584 | VA |
NPI | 1023510609 |
---|---|
Provider Name | Ms. Suzanne Thornton Drawbaugh |
First Address | Alexandria, VA 22310-3012 |
Second Address | Alexandria, VA 22310-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2018 |
Last Update Date | 28/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0813000584 | (05) | VA |