Provider Demographics
NPI:1740262138
Name:ROBERTSON, GLYNIS PATRICIA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:GLYNIS
Middle Name:PATRICIA
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8125 SWEET DIXIE LN
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-2338
Mailing Address - Country:US
Mailing Address - Phone:804-675-6362
Mailing Address - Fax:804-675-5678
Practice Address - Street 1:HUNTER HOLMES MCGUIRE VA MEDICAL CTR
Practice Address - Street 2:1201 BROADROCK BLVD
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-675-6362
Practice Address - Fax:804-675-5678
Is Sole Proprietor?:No
Enumeration Date:2005-11-19
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010755711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical