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