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General NPI Number Information
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NPI Number | 1497400220
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Entity Type | Organization
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Legal Business Name | MARKHAM PSYCHOLOGICAL AND DEAF SERVICES, LLC
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 4445 CORPORATION LN STE 169
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3262
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Country | US
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Telephone | 757-646-1246
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Fax |
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Provider Business Mailing Address
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Address Line | 4445 CORPORATION LN STE 169
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3262
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | HEIDI M JARVIS
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Credential |
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Telephone | 757-477-7861
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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 |
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License Number State |
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