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Organization

CARLA M. SHAFFER, PHD., LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARLA SHAFFER PHD., LCP (LICENSED CLINICAL PSYCHOLOGIST)
(804) 873-8755
Entity
Organization

Contact information

Practice address
17 E MAIN ST, #3, RICHMOND, VA 23219-2109
(804) 495-0676
Mailing address
3649 STONE HARBOR DR, MIDLOTHIAN, VA 23113-9200

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0810005414
VA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810005414
VA

Other

Enumeration date
01/23/2017
Last updated
01/23/2017
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