Individual
DR. BRIAN MATTINGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1695 KERNERSVILLE MEDICAL PKWY, KERNERSVILLE, NC 27284-7159
(336) 515-5000
Mailing address
513 GREAT PARK DR, NEWPORT NEWS, VA 23608-2033
(757) 871-7773
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005599
VA
Other
Enumeration date
03/07/2014
Last updated
01/11/2017
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