Healthcare Provider Details

I. General information

NPI: 1790596054
Provider Name (Legal Business Name): CHRISTOPHER ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

578 AZALEA RD STE 112
MOBILE AL
36609-1551
US

IV. Provider business mailing address

578 AZALEA RD STE 112
MOBILE AL
36609-1551
US

V. Phone/Fax

Practice location:
  • Phone: 251-303-9930
  • Fax:
Mailing address:
  • Phone: 251-303-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberALC01537
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberALC05137
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: