Healthcare Provider Details

I. General information

NPI: 1053865550
Provider Name (Legal Business Name): ROBIN ELIZABETH MOYHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 08/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 GATEPOST LN
OAK HILL VA
20171-2246
US

IV. Provider business mailing address

3014 GATEPOST LN
OAK HILL VA
20171-2246
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-1754
  • Fax:
Mailing address:
  • Phone: 703-391-1754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133000184
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: