Individual
DR. BRENT STUART ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CLNICAL PSYCHOLOGIST
Contact information
Practice address
6353 CENTER DR, SUITE 204, NORFOLK, VA 23502-4112
(757) 461-3313
(757) 461-8363
Mailing address
6353 CENTER DR, SUITE 204, NORFOLK, VA 23502-4112
(757) 461-3313
(757) 461-8363
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005522
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0810005522
LICENSE NUMBER
—
Enumeration date
09/22/2016
Last updated
09/22/2016
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