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General NPI Number Information
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NPI Number | 1740311042
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Entity Type | Individual
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Provider Name | ANDREA POWELL ARCONA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 2006 OLD GREENBRIER RD SUITE 6
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2648
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Country | US
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Telephone | 757-961-0567
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Fax | 757-961-0568
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Provider Business Mailing Address
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Address Line | 252 MARLENE ST
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-6750
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Country | US
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Telephone | 757-735-2890
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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 | 0810003019
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License Number State | VA
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