Individual
DR. NANCY TAYLOR MITCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD LCP
Contact information
Practice address
1709 COLLEY AVE, STE 311, NORFOLK, VA 23517
(757) 628-8337
(757) 628-5911
Mailing address
1709 COLLEY AVE, STE 311, NORFOLK, VA 23517
(757) 628-8337
(757) 628-5911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002730
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140543
ANTHEM BCBS
VA
01
—
541592464001
TRICARE NORTH REGION
VA
Enumeration date
07/26/2006
Last updated
07/08/2007
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