Individual
DR. ELLEN M KVETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP
Contact information
Practice address
2470 PRUDEN BLVD, SUFFOLK, VA 23434
(757) 539-1503
(757) 539-0107
Mailing address
184 BUSINESS PARK DRIVE, SUITE 200, VIRGINIA BEACH, VA 23462-6533
(757) 466-3336
(757) 455-5750
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
810001893
VA
103TC0700X
Clinical Psychologist
0810001893
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007702655
—
VA
Enumeration date
05/17/2006
Last updated
10/19/2009
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