Healthcare Provider Details

I. General information

NPI: 1518186212
Provider Name (Legal Business Name): DAVID THOMPSON BOND PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 KINGS WAY SUITE 2700
WILLIAMSBURG VA
23185-2505
US

IV. Provider business mailing address

856 J CLYDE MORRIS BLVD SUITE A
NEWPORT NEWS VA
23601-1318
US

V. Phone/Fax

Practice location:
  • Phone: 757-221-0110
  • Fax:
Mailing address:
  • Phone: 757-594-4006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810002421
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: