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Organization

WATERMARK PSYCHOLOGICAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LISA MAZZIO PSY.D. (CLINICAL PSYCHOLOGIST)
(757) 319-4650
Entity
Organization

Contact information

Practice address
821 W 21ST ST, SUITE 206, NORFOLK, VA 23517-1500
(757) 319-4650
(757) 644-5065
Mailing address
821 W 21ST ST, SUITE 206, NORFOLK, VA 23517-1500
(757) 319-4650
(757) 644-5065

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701005945
VA
103TC0700X
Clinical Psychologist
Primary
0810004778
VA

Other

Enumeration date
11/18/2014
Last updated
11/18/2014
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