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Individual

EDITH C LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
417 EMMET STREET, SOUTH, CHARLOTTESVILLE, VA 22904-4270
(434) 924-7034
(434) 924-4621
Mailing address
417 EMMET STREET, SOUTH, P.O. BOX 400270, CHARLOTTESVILLE, VA 22904-4270
(434) 924-7034
(434) 924-4621

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001206
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007706103
VA
Enumeration date
07/13/2005
Last updated
03/27/2013
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