Organization
AFFILIATED CLINICAL THERAPISTS
Active
Organization
AFFILIATED CLINICAL THERAPISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE M ROSS PHD (OWNER)
(757) 623-2228
Entity
Organization
Contact information
Practice address
4164 VIRGINIA BEACH BLVD STE 202, VIRGINIA BEACH, VA 23452-1762
(757) 623-2228
(757) 623-7186
Mailing address
4164 VIRGINIA BEACH BLVD STE 202, VIRGINIA BEACH, VA 23452-1762
(757) 623-2228
(757) 623-7186
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001655
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7728476
—
VA
Enumeration date
04/25/2007
Last updated
12/18/2024
Update your record
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