Individual
JEAN L CORCORAN
Active
Individual
JEAN L CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002806
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810002806
VA STATE LICENSE
VA
Enumeration date
11/05/2008
Last updated
06/11/2009
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