Individual
CAROLE CRUSE-OLIVIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
15301 LEE HWY, CENTREVILLE, VA 20121-2126
(703) 456-2222
Mailing address
43417 EDGEWATER ST, CHANTILLY, VA 20152-1751
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-0600056
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0813000532
VA BOARD OF PSYCHOLOGY
VA
01
—
PPS-0600056
COMMONWEALTH OF VA PUPIL PERSONNEL SERVICES LICENSE
VA
Enumeration date
03/02/2018
Last updated
03/02/2018
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