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General NPI Number Information
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NPI Number | 1932380128
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Entity Type | Organization
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Legal Business Name | PATRICIA WILLS, PHD., PLLC
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1092 LASKIN RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6362
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Country | US
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Telephone | 757-422-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 1092 LASKIN RD STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6362
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Country | US
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Telephone | 757-422-2408
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. PATRICIA WILLS
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Credential |
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Telephone | 757-422-2408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0810001950
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License Number State | VA
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