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General NPI Number Information
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NPI Number | 1619325727
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Entity Type | Organization
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Legal Business Name | DFAS-CL/JFLP
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 05/31/2016
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Provider Practice Location Address
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Address Line | 626 JOHN PAUL JONES CIR MENTAL HEALTH TRAINING
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City | PORTSMOUTH
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State | VA
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Zip | 23708-5000
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Country | US
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Telephone | 757-953-7641
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Fax |
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Provider Business Mailing Address
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Address Line | 626 JOHN PAUL JONES CIR MENTAL HEALTH TRAINING
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City | PORTSMOUTH
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State | VA
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Zip | 23708-5000
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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 | INTERNSHIP TRAINING DIRECTOR
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Name | DR. MICHAEL FRANKS
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Credential | PSY.D.
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Telephone | 757-953-7641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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