Individual
RAELYN LOISELLE ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1313 VINCENT PL, MC LEAN, VA 22101-3615
(501) 295-7119
Mailing address
2512 LAKEVALE DR, VIENNA, VA 22181-4028
(518) 223-2667
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
025822
NY
103TC2200X
Clinical Child & Adolescent Psychologist
0810008683
VA
Other
Enumeration date
03/02/2022
Last updated
03/31/2025
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