Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0813000782 | VA |
NPI | 1043837198 |
---|---|
Provider Name | Romeo Linaes Mosley JR. |
First Address | Chesapeake, VA 23324-3527 |
Second Address | Chesapeake, VA 23324-3527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2020 |
Last Update Date | 06/07/2020 |