Healthcare Provider Details

I. General information

NPI: 1124948823
Provider Name (Legal Business Name): JENNIFER LYNN ROBINSON ED.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S WESTERN AVE
CHEBOYGAN MI
49721-1842
US

IV. Provider business mailing address

605 S WESTERN AVE
CHEBOYGAN MI
49721-1842
US

V. Phone/Fax

Practice location:
  • Phone: 269-267-0134
  • Fax:
Mailing address:
  • Phone: 269-267-0134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number000033823
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: