Healthcare Provider Details

I. General information

NPI: 1295140077
Provider Name (Legal Business Name): HALEY ENGLAND KUTNER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5821 STAPLES MILL RD
RICHMOND VA
23228-5427
US

IV. Provider business mailing address

5821 STAPLES MILL ROAD
RICHMOND VA
23228-5427
US

V. Phone/Fax

Practice location:
  • Phone: 804-264-0966
  • Fax:
Mailing address:
  • Phone: 18042640966
  • Fax: 804-264-1029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5059
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810005445
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: