Organization
REVA K B O'HALLARN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REVA K B O'HALLARN PSY.D. (SOLE MEMBER)
(757) 873-1958
Entity
Organization
Contact information
Practice address
708 MOBJACK PL, NEWPORT NEWS, VA 23606-1957
(757) 873-1958
(757) 873-2143
Mailing address
708 MOBJACK PL, NEWPORT NEWS, VA 23606-1957
(757) 873-1958
(757) 873-2143
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003845
VA
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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