Organization
PENINSULA PSYCHOTHERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMAYA A. RUCKER PSY.D., LCP (DIRECTOR)
(757) 903-3284
Entity
Organization
Contact information
Practice address
306 HIGH POINT RD, WILLIAMSBURG, VA 23185-5847
(757) 903-3284
Mailing address
306 HIGH POINT RD, WILLIAMSBURG, VA 23185-5847
(757) 903-3284
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004168
VA
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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