Organization
SOAR BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN W AHAVA PH.D. (PSYCHOLOGIST/SOLE MEMBER)
(478) 595-3400
Entity
Organization
Contact information
Practice address
700 FLUME RUN APT 102, NEWPORT NEWS, VA 23602-8900
(478) 595-3400
Mailing address
700 FLUME RUN APT 102, NEWPORT NEWS, VA 23602-8900
(478) 595-3400
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TF0200X
Forensic Psychologist
—
—
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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