| NPI | 1578970927 |
|---|---|
| Former Legal Business Name | TIDEWATER CHILD AND FAMILY BEHAVIORAL HEALTH CENTER PLL |
| Entity Type | Organization |
| Authorized Contact | DONALD FRANKLIN WALKER Owner 757-609-2719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 0810004375) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004375) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2024-09-11 |