Individual
DR. THEODORE M STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3076 BRICKHOUSE CT, VIRGINIA BEACH, VA 23452-6859
(757) 486-0909
(757) 340-7518
Mailing address
3076 BRICKHOUSE CT, VIRGINIA BEACH, VA 23452-6859
(757) 486-0909
(757) 340-7518
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000970
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007788461
—
VA
Enumeration date
02/06/2007
Last updated
11/20/2009
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