Individual
DR. VICTORIA PEZZULLO TATE
Active
Individual
DR. VICTORIA PEZZULLO TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LCP
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0810003679
VA
103TC0700X
Clinical Psychologist
Primary
0810003679
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269349
ANTHEM
VA
Enumeration date
11/28/2006
Last updated
03/26/2025
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