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General NPI Number Information
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NPI Number | 1922574078
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Entity Type | Individual
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Provider Name | ASHLEY MITCHELL-ROBERTS PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2018
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Last Update Date | 10/16/2018
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Provider Practice Location Address
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Address Line | 321 LYNN ST STE A
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City | DANVILLE
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State | VA
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Zip | 24541-1421
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Country | US
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Telephone | 434-857-2459
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Fax | 434-857-2735
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Provider Business Mailing Address
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Address Line | PO BOX 154
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City | BELEWS CREEK
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State | NC
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Zip | 27009-0154
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Country | US
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Telephone | 336-403-7708
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Fax | 434-857-2735
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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 | 0810005999
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License Number State | VA
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