Individual
LAUREN SERVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 POWELL CREEK DR, CHARLOTTESVILLE, VA 22911-7402
(434) 975-0599
Mailing address
2801 POWELL CREEK DR, CHARLOTTESVILLE, VA 22911-7402
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0813000411
—
VA
Enumeration date
03/28/2018
Last updated
03/28/2018
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