Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 6401009507 | MI |
NPI | 1003180878 |
---|---|
Provider Name | Ms. Robin Dawn Edison |
First Address | Ann Arbor, MI 48103 |
Second Address | Ann Arbor, MI 48103-9394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2012 |
Last Update Date | 27/02/2012 |