Organization
COMMONWEALTH PSYCHOLOGICAL SERVICES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JESSICA LYNNE GALLARO (OFFICE COORDINATOR)
(540) 437-4820
Entity
Organization
Contact information
Practice address
2322 BLUE STONE HILL DR, SUITE 280, HARRISONBURG, VA 22801-5403
(540) 437-4820
(540) 437-4823
Mailing address
2322 BLUE STONE HILL DR, SUITE 280, HARRISONBURG, VA 22801-5403
(540) 437-4820
(540) 437-4823
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003002
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190001472
MEDICARE PTAN
VA
Enumeration date
01/15/2009
Last updated
01/15/2009
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