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General NPI Number Information
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NPI Number | 1548632995
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Entity Type | Organization
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Legal Business Name | BELCHER ENTERPRISES LLC
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 2300 COMMONWEALTH DR SUITE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1622
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Country | US
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Telephone | 434-812-4009
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 COMMONWEALTH DR SUITE 100
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1622
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Country | US
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Telephone | 434-812-4009
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL ELIJAH BELCHER
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Credential |
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Telephone | 434-812-4009
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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 | 0810002117
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License Number State | VA
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