Provider Demographics
NPI:1255799292
Name:RANKIN, BRONWEN WHEELER (PHD)
Entity type:Individual
Prefix:DR
First Name:BRONWEN
Middle Name:WHEELER
Last Name:RANKIN
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 1:313 PARK AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3303
Mailing Address - Country:US
Mailing Address - Phone:703-424-2909
Mailing Address - Fax:703-859-7675
Practice Address - Street 1:345 LITTLE FALLS ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-2636
Practice Address - Country:US
Practice Address - Phone:202-321-6225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003743103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical