Individual
NICOLE DUTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
(757) 726-6077
Mailing address
207 SHERBROOKE DR, NEWPORT NEWS, VA 23602-7479
(865) 235-4368
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005852
VA
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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