Individual
BRIAN MUTCHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1201 BROAD ROCK BLVD, VAMC / MENTAL HEALTH SERVICE LINE, RICHMOND, VA 23249-0001
(804) 675-5000
(804) 675-6853
Mailing address
1201 BROAD ROCK BLVD, VAMC / MENTAL HEALTH SERVICE LINE, RICHMOND, VA 23249-0001
(804) 675-5000
(804) 675-6853
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002766
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810002766
STATE LICENSE TO PRACTICE
VA
Enumeration date
05/24/2006
Last updated
07/08/2007
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