Healthcare Provider Details

I. General information

NPI: 1225589815
Provider Name (Legal Business Name): MARSDEN & ASSOCIATES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 PROFESSIONAL CIR STE 102
VIRGINIA BEACH VA
23455-6442
US

IV. Provider business mailing address

4551 PROFESSIONAL CIR STE 102
VIRGINIA BEACH VA
23455-6442
US

V. Phone/Fax

Practice location:
  • Phone: 757-971-1381
  • Fax:
Mailing address:
  • Phone: 757-971-1381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: ALLAN BRYAN MARSDEN
Title or Position: FOUNDER MEMBER
Credential: DR
Phone: 757-971-1381