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General NPI Number Information
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NPI Number | 1396998613
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Entity Type | Organization
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Legal Business Name | KNOXVILLE PSYCHOLOGICAL CENTER, PLLC
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 4048 SUTHERLAND AVE
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City | KNOXVILLE
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State | TN
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Zip | 37919-5103
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Country | US
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Telephone | 865-450-9880
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Fax |
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Provider Business Mailing Address
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Address Line | 4048 SUTHERLAND AVE
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City | KNOXVILLE
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State | TN
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Zip | 37919-5103
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Country | US
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Telephone | 865-450-9880
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBYN LYNNE BRANCA
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Credential | PH. D.
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Telephone | 865-450-9880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2662
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License Number State | TN
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