Healthcare Provider Details

I. General information

NPI: 1245492909
Provider Name (Legal Business Name): ROBYN SUZANNE NUNLEY PH.D., L.P.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4337 COX RD
GLEN ALLEN VA
23060-3359
US

IV. Provider business mailing address

4337 COX RD
GLEN ALLEN VA
23060-3359
US

V. Phone/Fax

Practice location:
  • Phone: 540-553-5438
  • Fax:
Mailing address:
  • Phone: 540-553-5438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701005124
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: