Organization
SPECTRUM TRANSFORMATION GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CEDRIC MOORE JR. MBA (CHIEF EXECUTIVE OFFICER)
(804) 317-4307
Entity
Organization
Contact information
Practice address
221 STONEBRIDGE PLAZA AVE STE C, NORTH CHESTERFIELD, VA 23225-6972
(804) 378-6141
Mailing address
221 STONEBRIDGE PLAZA AVE STE C, NORTH CHESTERFIELD, VA 23225-6972
(804) 378-6141
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/03/2010
Last updated
11/17/2020
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