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Individual

DR. EDWARD HUGH TENISON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3635 MANASSAS DR, SUITE A, ROANOKE, VA 24018-4031
(540) 774-4686
(540) 989-8893
Mailing address
2121 LAKE AVE., VA MEDICAL CENTER, FT. WAYNE, IN 46805
(260) 426-5431

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002134
VA

Other

Enumeration date
07/19/2006
Last updated
01/22/2010
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