Healthcare Provider Details

I. General information

NPI: 1073250460
Provider Name (Legal Business Name): EMILY MIYOKO ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W 24TH ST STE A
NORTH NEWTON KS
67117-8073
US

IV. Provider business mailing address

610 STONE CREEK DR
NEWTON KS
67114-8763
US

V. Phone/Fax

Practice location:
  • Phone: 316-804-7240
  • Fax:
Mailing address:
  • Phone: 316-847-1698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: