Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 7006 | LA |
N | 225C00000X | Rehabilitation Counselor | 00217005 | LA |
NPI | 1093258618 |
---|---|
Provider Name | Miss Nicole Robinson |
First Address | Kenner, LA 70065-1273 |
Second Address | Kenner, LA 70065-1273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2016 |
Last Update Date | 04/09/2020 |