Individual
EDWARD HULAND SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
424 N MAIN ST, SUITE #4, SUFFOLK, VA 23434-4428
(757) 539-9458
(757) 539-9468
Mailing address
PO BOX 1066, SUFFOLK, VA 23439-1066
(757) 539-9458
(757) 539-9468
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
0810002426
VA
103TC0700X
Clinical Psychologist
0810002426
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088631
SENTARA
VA
01
—
283200
BLUE CROSS BLUE SHIELD
VA
01
—
443602
PHP-MD, MAMSI, ETC. NUMBE
VA
Enumeration date
08/30/2006
Last updated
09/11/2025
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