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General NPI Number Information
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NPI Number | 1750696001
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Entity Type | Organization
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Legal Business Name | E. WAYNE SLOOP, PH.D., PC
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 20715 TIMBERLAKE RD SUITE 103
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City | LYNCHBURG
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State | VA
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Zip | 24502-7200
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Country | US
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Telephone | 434-237-7792
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Fax | 434-237-7793
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Provider Business Mailing Address
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Address Line | 20715 TIMBERLAKE ROAD SUITE 103
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City | LYNCHBURG
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State | VA
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Zip | 24502-7207
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Country | US
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Telephone | 434-237-7792
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Fax | 434-237-7793
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. E. WAYNE SLOOP
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Credential | PH.D.
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Telephone | 434-237-7792
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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 | 0810000639
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License Number State | VA
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