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Provider Information for 1467766386



DR. ROBYN A VAN BRUNT PH.D.

Other Name:   ROBYN ZAKALIK
Gender: FEMALE

Individual NPI: 1467766386

Calendar Last Updated: 2016-12-19

Details

Name Value
NPI 1467766386
Enumeration Date 2010-08-03
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 510 PRINCESS ANNE ST STE. 101
FREDERICKSBURG, VA 22401-6077
United States

Phone: 540-445-1125 | Fax:
View Map External Link
Primary Practice Address 510 PRINCESS ANNE ST STE. 101
FREDERICKSBURG, VA 22401-6077
United States

Phone: 540-445-1125 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 103TC0700X - Psychologist Clinical VA 0810004286
No 103TC1900X - Psychologist Counseling VA 0810004286
Other Identifiers
Issuer State Number