Behavioral Health & Social Service Providers (519) PERSON CLASS (8932.1)

Name	Value
PROVIDER TYPE	Behavioral Health & Social Service Providers
CLASSIFICATION	Psychologist
AREA OF SPECIALIZATION	Psychotherapy
STATUS	Inactive
DATE INACTIVATED	2009-04-22 00:00:00
VA CODE	V010416
X12 CODE	103TP2700X
INDIVIDUAL/NON	INDIVIDUAL
MASTER ENTRY FOR VUID	YES
VUID	5252372
EFFECTIVE DATE/TIME	2018-04-02 15:35:57 STATUS: INACTIVE