Individual
MATHIAS CARPENTER SOUCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1210 PROGRESSIVE DR STE 101, CHESAPEAKE, VA 23320-2849
(757) 386-4578
(757) 386-4604
Mailing address
1210 PROGRESSIVE DR STE 101, CHESAPEAKE, VA 23320-2849
(757) 386-4578
(757) 386-4604
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810007899
VA
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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