Healthcare Provider Details

I. General information

NPI: 1023478922
Provider Name (Legal Business Name): CASSANDRA COPELAND ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W MOANA LN
RENO NV
89509-4955
US

IV. Provider business mailing address

1280 TERMINAL WAY SUITE 3
RENO NV
89502-3219
US

V. Phone/Fax

Practice location:
  • Phone: 775-433-2099
  • Fax:
Mailing address:
  • Phone: 775-337-9359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: