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General NPI Number Information
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NPI Number | 1174781215
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Entity Type | Organization
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Legal Business Name | ASSOCIATED EDUCATIONS SERVICES OF VA., INC.
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 2817 NORTH AVE
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City | RICHMOND
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State | VA
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Zip | 23222-3610
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Country | US
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Telephone | 804-321-2777
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Fax | 804-321-0920
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Provider Business Mailing Address
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Address Line | 2817 NORTH AVE
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City | RICHMOND
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State | VA
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Zip | 23222-3610
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Country | US
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Telephone | 804-321-2777
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Fax | 804-321-0920
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. LINDA WOOD HENSLEY
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Credential |
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Telephone | 804-321-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | BA2096483
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License Number State | VA
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