Healthcare Provider Details

I. General information

NPI: 1831614304
Provider Name (Legal Business Name): EMILY ZALEWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 NINE MILE RD
RICHMOND VA
23223-4831
US

IV. Provider business mailing address

3820 NINE MILE RD
RICHMOND VA
23223-4831
US

V. Phone/Fax

Practice location:
  • Phone: 804-343-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number0603883
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: