Healthcare Provider Details
I. General information
NPI: 1982718284
Provider Name (Legal Business Name): HAMPTON ROADS NEUROPSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1604 HILLTOP WEST EXECUTIVE CENTER SUITE 216
VIRGINIA BEACH VA
23451
US
IV. Provider business mailing address
1604 HILLTOP WEST EXECUTIVE CENTER SUITE 216
VIRGINIA BEACH VA
23451
US
V. Phone/Fax
- Phone: 757-498-9585
- Fax: 757-468-1685
- Phone: 757-498-9585
- Fax: 757-468-1685
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
W
SAUTTER
Title or Position: OWNER/DIRECTOR
Credential: PH.D
Phone: 757-498-9585