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Individual

DR. ACE LEONARD TUBBS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1560 BORDEAUX PL, NORFOLK, VA 23509-1314
(757) 622-6242
Mailing address
1560 BORDEAUX PL, NORFOLK, VA 23509-1314
(757) 622-6242

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000253
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007700563
VA
01
433818
ANTHEM BC
VA
Enumeration date
11/21/2005
Last updated
05/13/2016
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