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General NPI Number Information
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NPI Number | 1194219618
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Entity Type | Individual
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Provider Name | ERIC RUSSELL WARD MA
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Gender | Male
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 223 MCLAWS CIR
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-5649
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Country | US
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Telephone | 757-564-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 EXECUTIVE DR STE C
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City | HAMPTON
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State | VA
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Zip | 23666-6604
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Country | US
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Telephone | 757-256-9683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | VA
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