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Individual

JOHN CHRISTIAN COLLETTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
9515 CATESBY LN, RICHMOND, VA 23238-4453
(804) 741-7500
(804) 741-7900
Mailing address
9515 CATESBY LN, RICHMOND, VA 23238-4453
(804) 741-7500
(804) 741-7900

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002516
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007712588
VA
01
291855
BCBS
VA
01
680001531
PTAN
VA
Enumeration date
05/12/2006
Last updated
02/19/2013
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