Individual
LEWIS JEROME TAYLOR III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1500 E LITTLE CREEK ROAD, SUITE 205, NORFOLK, VA 23518
(757) 587-4744
(757) 587-4947
Mailing address
1500 E LITTLE CREEK ROAD, SUITE 205, NORFOLK, VA 23518
(757) 587-4744
(757) 587-4947
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001309
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007746393
—
VA
01
—
279379
BCBS
VA
Enumeration date
04/11/2006
Last updated
08/21/2015
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