Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | E-8043 | OH |
N | 101YM0800X | Mental Health Counselor | E-8043 | OH |
N | 101YP1600X | Pastoral Counselor | E-8043 | OH |
N | 101YP2500X | Professional Counselor | E-8043 | OH |
Y | 101YP2500X | Professional Counselor | LPC.0013874 | CO |
NPI | 1366770844 |
---|---|
Provider Name | Mrs. Diane M. Robinson |
First Address | Pueblo, CO 81001-1366 |
Second Address | Pueblo, CO 81001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2009 |
Last Update Date | 24/08/2018 |