Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 2662 | TN |
NPI | 1023215985 |
---|---|
Provider Name | Robyn Lynne Branca |
First Address | Knoxville, TN 37919-5103 |
Second Address | Knoxville, TN 37919-5103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 08/07/2007 |