Organization
SPECTRUM TRANSFORMATION GROUP, LLC
Active
Other names
Spectrum Transformation Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CEDRIC A MOORE JR. (PRESIDENT AND CEO)
(804) 378-6141
Entity
Organization
Contact information
Practice address
221 STONEBRIDGE PLAZA AVE STE C, NORTH CHESTERFIELD, VA 23225-6972
(804) 378-6141
Mailing address
221 STONEBRIDGE PLAZA AVE STE C, NORTH CHESTERFIELD, VA 23225-6972
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
161707010
VA
103TB0200X
Cognitive & Behavioral Psychologist
—
VA
103TC2200X
Clinical Child & Adolescent Psychologist
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174855985
NPI
VA
Enumeration date
02/11/2015
Last updated
03/24/2020
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