| NPI | 1366956096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE DUCHARME Clinical Neuropsychologist 757-301-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: VA 0810004265) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2019-03-01 |