Healthcare Provider Details

I. General information

NPI: 1043765944
Provider Name (Legal Business Name): LETHER CHRISTINE VAVASSOEUR PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2016
Last Update Date: 08/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 K ST NE
WASHINGTON DC
20002-3530
US

IV. Provider business mailing address

660 K ST NE
WASHINGTON DC
20002-3530
US

V. Phone/Fax

Practice location:
  • Phone: 202-698-4733
  • Fax:
Mailing address:
  • Phone: 202-698-4733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: