Doctor Name: | DR. EDGAR WAYNE SLOOP |
NPI Number: | 1003028564 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 0810000639 |
Business Practice Address: | 20715 Timberlake Rd Ste 103 Lynchburg, VA - 245027200 |
Business Phone Number: | 4342377792 |
Business Fax Number: | 4342377793 |
Mailing Address: | 20715 Timberlake Rd, Ste 103 LYNCHBURG |
State: | VA |
Postal Code: | 245027200 |
Phone Number: | 4342377792 |
Fax Number: | 4342377793 |
NPI Enumeration Date: | 05/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0810000639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |