Provider Demographics
NPI:1932956471
Name:ROBERTS, RACHEL LYNNE (PHD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LYNNE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 HARRISON POINT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES CITY
Mailing Address - State:VA
Mailing Address - Zip Code:23030-2738
Mailing Address - Country:US
Mailing Address - Phone:804-370-7342
Mailing Address - Fax:
Practice Address - Street 1:1117 A ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5003
Practice Address - Country:US
Practice Address - Phone:804-512-3127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation