MEDICARE: MS. ROBIN LYNN BURNS LLMSW

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	1041C0700X	Clinical Social Worker	6801089655	MI

General Provider Information

NPI Number	:	1689805467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN LYNN BURNS LLMSW

Provider Business Mailing Address
First Line	:	1102 MACKIN RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48503-1204
Country	:	US
Telephone Number	:	810-257-3676
Fax Number	:	810-257-0713

Provider Business Practice Location Address
First Line	:	1102 MACKIN ROAD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48503-0000
Country	:	US
Telephone Number	:	810-257-3676
Fax Number	:	810-257-0713

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

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	02/01/2012

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