MEDICARE: THOMAS D ROBBINS PH.D.

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	0210	KY

General Provider Information

NPI Number	:	1770865438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS D ROBBINS PH.D.

Provider Business Mailing Address
First Line	:	3511 HUGHES RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4331
Country	:	US
Telephone Number	:	502-648-2155
Fax Number	:

Provider Business Practice Location Address
First Line	:	3511 HUGHES RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4331
Country	:	US
Telephone Number	:	502-648-2155
Fax Number	:

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

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	09/19/2011

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