Healthcare Provider Details

I. General information

NPI: 1275834590
Provider Name (Legal Business Name): ROBIN E. FROST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 HUNTERS RIDGE RD
SAGAMORE BEACH MA
02562-2710
US

IV. Provider business mailing address

12 HUNTERS RIDGE RD
SAGAMORE BEACH MA
02562-2710
US

V. Phone/Fax

Practice location:
  • Phone: 508-737-8639
  • Fax:
Mailing address:
  • Phone: 508-737-8639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number313589
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: