Healthcare Provider Details

I. General information

NPI: 1629901954
Provider Name (Legal Business Name): ROBIN WYMER MCJ, CP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S 8TH ST
WEST BRANCH MI
48661-1242
US

IV. Provider business mailing address

511 GRIFFIN RD
WEST BRANCH MI
48661-9251
US

V. Phone/Fax

Practice location:
  • Phone: 989-345-5511
  • Fax: 989-747-3014
Mailing address:
  • Phone: 989-345-5571
  • Fax: 989-747-3014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: