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General NPI Number Information
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NPI Number | 1942579693
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Entity Type | Organization
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Legal Business Name | VERDON PC
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Dates
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Enumeration Date | 12/27/2011
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 3091 BRICKHOUSE CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-6860
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Country | US
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Telephone | 757-557-6328
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Fax |
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Provider Business Mailing Address
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Address Line | 729 TRIO LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-5931
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Country | US
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Telephone | 757-340-2712
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELE P MCNEILL
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Credential | PH.D.
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Telephone | 757-340-2712
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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 | 0810002194
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License Number State | VA
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