Provider Demographics
NPI:1134943871
Name:SOTO COLLAZO, BARBARA (PSYD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:SOTO COLLAZO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6034
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-0034
Mailing Address - Country:US
Mailing Address - Phone:619-839-9938
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 6034
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0034
Practice Address - Country:US
Practice Address - Phone:619-839-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008644103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical