Healthcare Provider Details

I. General information

NPI: 1922048834
Provider Name (Legal Business Name): ROBERT S RAMBO LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 W MAIN ST
TAZEWELL VA
24651
US

IV. Provider business mailing address

PO BOX 810
CEDAR BLUFF VA
24609
US

V. Phone/Fax

Practice location:
  • Phone: 276-988-7961
  • Fax: 276-988-0081
Mailing address:
  • Phone: 276-964-6702
  • Fax: 276-964-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: