Healthcare Provider Details

I. General information

NPI: 1417884404
Provider Name (Legal Business Name): CHAMEKIA LASHONDA ROBINSON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5038 S HARDY DR
TEMPE AZ
85282-6626
US

IV. Provider business mailing address

5038 S HARDY DR APT 1142
TEMPE AZ
85282-6645
US

V. Phone/Fax

Practice location:
  • Phone: 314-348-7288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: