Doctor Name: | DR. VIRGINIA MARY LAWRENCE |
NPI Number: | 1962653824 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 3779 |
Business Practice Address: | 11589 E Deer Trail Ln Dewey, AZ - 863275736 |
Business Phone Number: | 9287722897 |
Business Fax Number: | 9287722897 |
Mailing Address: | 11589 E Deer Trail Ln, DEWEY |
State: | AZ |
Postal Code: | 863275736 |
Phone Number: | 9287722897 |
Fax Number: | 9287722897 |
NPI Enumeration Date: | 10/08/2008 |
NPI Last Update Date: | 10/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 3779 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |