Healthcare Provider Details

I. General information

NPI: 1013590470
Provider Name (Legal Business Name): AARON KEITH ROBINSON FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 FOREST MERE DR
RIVERVIEW FL
33578-8629
US

IV. Provider business mailing address

7201 FOREST MERE DR
RIVERVIEW FL
33578-8629
US

V. Phone/Fax

Practice location:
  • Phone: 813-732-1180
  • Fax:
Mailing address:
  • Phone: 813-732-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. PAMELA YVONNE ROBINSON
Title or Position: PRESIDENT
Credential:
Phone: 813-732-1180