Provider Demographics
NPI:1467766386
Name:VAN BRUNT, ROBYN A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:A
Last Name:VAN BRUNT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROBYN
Other - Middle Name:A
Other - Last Name:ZAKALIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:615 EMANCIPATION HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8407
Mailing Address - Country:US
Mailing Address - Phone:540-268-3388
Mailing Address - Fax:
Practice Address - Street 1:615 EMANCIPATION HWY STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8407
Practice Address - Country:US
Practice Address - Phone:540-268-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004286103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling