MEDICARE: ROBIN J CHRISTOPHERSON LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	84501	CA
2	106H00000X	Marriage & Family Therapist	35001968A	IN

General Provider Information

NPI Number	:	1093103533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN J CHRISTOPHERSON LMFT

Provider Business Mailing Address
First Line	:	14074 TRADE CENTER DR STE 137
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-4570
Country	:	US
Telephone Number	:	317-458-5575
Fax Number	:

Provider Business Practice Location Address
First Line	:	14074 TRADE CENTER DR STE 137
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-4570
Country	:	US
Telephone Number	:	949-291-9345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2015
Last Update Date	:	02/14/2020

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