Individual
DR. DEREK ORLANDO BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1970 ROANOKE BLVD, PSYCHOLOGY (116B1), SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1976
Mailing address
1970 ROANOKE BLVD, PSYCHOLOGY (116B1), SALEM, VA 24153-6404
(540) 982-2463
(540) 224-1976
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004356
VA
Other
Enumeration date
04/16/2009
Last updated
01/02/2014
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