Provider Demographics
NPI:1851824791
Name:SOTOLONGO, DONNA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:SOTOLONGO
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 E KINGS RD
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7712
Mailing Address - Country:US
Mailing Address - Phone:908-612-2467
Mailing Address - Fax:
Practice Address - Street 1:2625 E KINGS RD
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7712
Practice Address - Country:US
Practice Address - Phone:908-612-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005650103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical