Provider Demographics
NPI:1245540889
Name:GOW, CHRISTINE HELENA (PSYD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:HELENA
Last Name:GOW
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 1:1950 GLENN MITCHELL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-0168
Mailing Address - Country:US
Mailing Address - Phone:757-507-0600
Mailing Address - Fax:757-689-3785
Practice Address - Street 1:1950 GLENN MITCHELL DR STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0168
Practice Address - Country:US
Practice Address - Phone:757-507-0600
Practice Address - Fax:757-689-3785
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004322103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical