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General NPI Number Information
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NPI Number | 1417774191
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Entity Type | Individual
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Provider Name | GABRIELLA SCALZO PHD, LCP
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Gender |
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 7760 SHRADER RD STE B
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City | HENRICO
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State | VA
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Zip | 23228-2552
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Country | US
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Telephone | 804-591-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 2650A JUDES FERRY RD # A
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City | POWHATAN
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State | VA
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Zip | 23139-5215
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Country | US
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Telephone | 757-705-1099
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810008659
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License Number State | VA
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