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General NPI Number Information
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NPI Number | 1841447596
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Entity Type | Individual
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Provider Name | JENELLE ROBINSON ANTHONY PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 4141 W WILSON RD BLDG 1600
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City | INDIAN HEAD
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State | MD
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Zip | 20640-5162
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Country | US
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Telephone | 301-744-4601
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 S VEITCH ST APT 407
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City | ARLINGTON
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State | VA
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Zip | 22206-3064
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Country | US
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Telephone | 443-803-3336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04842
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License Number State | MD
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