Individual
DR. KRYSTAL STUDIVANT NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1 PARK WEST CIR STE 306N, MIDLOTHIAN, VA 23114-5552
(804) 719-1955
(804) 420-9680
Mailing address
1 PARK WEST CIR STE 306N, MIDLOTHIAN, VA 23114-5552
(804) 719-1955
(804) 420-9680
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005486
VA
103TC2200X
Clinical Child & Adolescent Psychologist
0810005486
VA
Other
Enumeration date
04/15/2014
Last updated
09/14/2018
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