Individual
JEAN L CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
9702 GAYTON RD, #181, RICHMOND, VA 23238-4907
(804) 741-7500
(804) 741-7900
Mailing address
9702 GAYTON RD, #181, RICHMOND, VA 23238-4907
(804) 741-7500
(804) 741-7900
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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