Healthcare Provider Details

I. General information

NPI: 1619483476
Provider Name (Legal Business Name): KRISTINA D ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 12/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 E MARKET ST STE 100B
GREENSBORO NC
27401-3282
US

IV. Provider business mailing address

4593 WORTHING CHASE DR
GREENSBORO NC
27406-9802
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-0109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: