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Organization
FORMAN PSYCHOLOGICAL SERVICES LLC
Active
Organization
FORMAN PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBEKAH FORMAN PH.D. (LICENSED CLINICAL PSYCHOLOGIST)
(804) 554-1760
Entity
Organization
Contact information
Practice address
2800 N PARHAM RD STE 107, RICHMOND, VA 23294-4409
(804) 554-1760
Mailing address
2800 N PARHAM RD STE 107, RICHMOND, VA 23294-4409
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0810005256
VA
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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