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General NPI Number Information
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NPI Number | 1548752439
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Entity Type | Organization
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Legal Business Name | SHIFTLESS WANDERER LLC
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 2014 CHARLES ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3417
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Country | US
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Telephone | 425-238-2765
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Fax | 276-258-0608
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Provider Business Mailing Address
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Address Line | 2014 CHARLES ST
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3417
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Country | US
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Telephone | 425-238-2765
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Fax | 276-258-0608
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBIN T. BARRE
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Credential | LMHC, PHD
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Telephone | 425-238-2765
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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 | 60754200
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License Number State | WA
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