Healthcare Provider Details

I. General information

NPI: 1043831324
Provider Name (Legal Business Name): NATHEO ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 SW 21ST ST
TOPEKA KS
66604-3174
US

IV. Provider business mailing address

2101 SW 21ST ST
TOPEKA KS
66604-3174
US

V. Phone/Fax

Practice location:
  • Phone: 816-510-0117
  • Fax: 913-967-3535
Mailing address:
  • Phone: 816-510-0117
  • Fax: 913-967-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-158878
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: