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General NPI Number Information
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NPI Number | 1114341765
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Entity Type | Organization
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Legal Business Name | INTEGRATED BEHAVIORAL HEALTH CARE
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 1153 TAYLOR RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4081
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Country | US
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Telephone | 757-232-5062
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Fax |
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Provider Business Mailing Address
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Address Line | 1153 TAYLOR RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4081
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Country | US
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Telephone | 757-232-5062
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Fax |
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Authorized Official
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Title or Position | OFFICE / OPERATIONS MANAGER
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Name | MELISSA ANN FRANCOIS
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Credential |
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Telephone | 757-232-5062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810004863
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License Number State | MO
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