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General NPI Number Information
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NPI Number | 1902488984
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Entity Type | Organization
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Legal Business Name | MARIA C. RACITI PH. D., P. C.
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 11847 CANON BLVD STE 12
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4528
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Country | US
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Telephone | 757-873-0408
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Fax |
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Provider Business Mailing Address
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Address Line | 11847 CANON BLVD STE 12
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4528
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Country | US
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Telephone | 757-873-0408
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MARIA C. RACITI
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Credential | PHD.
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Telephone | 757-873-0408
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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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