Healthcare Provider Details

I. General information

NPI: 1831256973
Provider Name (Legal Business Name): ROBIN C DOLE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9625 SURVEYOR CT SUITE 110
MANASSAS VA
20110-4422
US

IV. Provider business mailing address

4885 OAKCREST DR
FAIRFAX VA
22030-4568
US

V. Phone/Fax

Practice location:
  • Phone: 703-967-4277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0701003524
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: