MEDICARE: RAYSHAEL ROSE ROBINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1588527659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYSHAEL ROSE ROBINSON

Provider Business Mailing Address
First Line	:	1520 TWIN OAKS LN APT 108
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4779
Country	:	US
Telephone Number	:	347-849-1519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 TWIN OAKS LN APT 108
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-4779
Country	:	US
Telephone Number	:	347-849-1519
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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