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1811130107
DEREK ORLANDO BACCHUS
SALEM, VA
NPI
1811130107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: VA 0810004356)
Enumeration Date
2009-04-16
Last Update Date
2014-01-02
Business Address
Dr. DEREK ORLANDO BACCHUS Ph.D.
1970 ROANOKE BLVD PSYCHOLOGY (116B1)
SALEM, VA 24153-6404
Phone number: 540-982-2463
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Mailing Address
Dr. DEREK ORLANDO BACCHUS Ph.D.
1970 ROANOKE BLVD PSYCHOLOGY (116B1)
SALEM, VA 24153-6404
Phone number: 540-982-2463
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