Healthcare Provider Details

I. General information

NPI: 1639669245
Provider Name (Legal Business Name): DENISE MOORE ROBINSON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N NINTH ST
RICHMOND VA
23219-1933
US

IV. Provider business mailing address

5619 HERELD GREEN DR
CHESTERFIELD VA
23832-4031
US

V. Phone/Fax

Practice location:
  • Phone: 804-780-7850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: