| Name | Value |
|---|---|
| PROVIDER TYPE | Behavioral Health & Social Service Providers |
| CLASSIFICATION | Psychologist |
| DEFINITION | A psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, intervention and research. |
| AREA OF SPECIALIZATION | Family |
| STATUS | Active |
| VA CODE | V010405 |
| X12 CODE | 103TF0000X |
| SPECIALTY CODE | 62 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252348 |
| EFFECTIVE DATE/TIME |
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