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Individual
TERI ANN BISTARKEY
Active
Individual
TERI ANN BISTARKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004677
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912197559
NPI
VA
05
—
1912197559
—
VA
Enumeration date
03/17/2006
Last updated
10/27/2014
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