| NPI | 1114002581 |
|---|---|
| Doing Business As | SPECTRUM PSYCHOLOGICAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | CARL RICHARD ELLIS Owner 757-640-1882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810001913) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-09-04 |