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Individual

RONALD WOODROW BRILL II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
800 EUCLID AVE, BRISTOL, VA 24201-3916
(276) 591-1122
(276) 591-1150
Mailing address
800 EUCLID AVE, BRISTOL, VA 24201-3916
(276) 591-1122
(276) 591-1150

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002356
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007727
VALUE OPTIONS
01
056271
ANTHEM
01
4037975
BC BS TN
01
87726
UNITED BEHAVIORAL HEALTH
Enumeration date
11/30/2006
Last updated
09/11/2007
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