Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | ||
Y | 101YP2500X | Professional Counselor | 6401010239 | MI |
NPI | 1003298746 |
---|---|
Provider Name | Monet Robinson |
First Address | Redford, MI 48239-1260 |
Second Address | Redford, MI 48239-1260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 29/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
382833497 | (05) | MI |
6401010239 | MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BOARD OF COUNSELING (01) | MI |