Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | MO 2011032369 | MO |
NPI | 1003186891 |
---|---|
Provider Name | Stephanie J Robbins |
First Address | Springfield, MO 65804-4264 |
Second Address | Springfield, MO 65804-4376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 15/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
497140905 | (05) | MO |