| Doctor Name: | DR. SANDRA SMALL DUIS |
| NPI Number: | 1104846518 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 0810002737 |
| Business Practice Address: | 1563 Crossings Centre Drive Suite 200 Forest, VA - 24551 |
| Business Phone Number: | 4345251907 |
| Business Fax Number: | 4345251908 |
| Mailing Address: | 1563 Crossings Centre Drive, Suite 200 FOREST |
| State: | VA |
| Postal Code: | 24551 |
| Phone Number: | 4345251907 |
| Fax Number: | 4345251908 |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 08/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810002737 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |