Basic Information
| Provider Information | |||||||||
| NPI: | 1558384800 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEHRLIN | ||||||||
| FirstName: | MARK | ||||||||
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| Credential: | PSYD CLINICAL PSYCHO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 N CENTER DR | ||||||||
| Address2: | SUITE 141 BUILDING 11 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574660700 | ||||||||
| FaxNumber: | 7574614826 | ||||||||
| Practice Location | |||||||||
| Address1: | 420 N CENTER DR | ||||||||
| Address2: | SUITE 141 BUILDING 11 | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574660700 | ||||||||
| FaxNumber: | 7574614826 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 0810002036 | VA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.