Individual
BLYTHE LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 HARTMAN ST BLDG F, RICHMOND, VA 23223-2458
(804) 652-3612
Mailing address
2401 HARTMAN ST BLDG F, RICHMOND, VA 23223-2458
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000833
VA
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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