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General NPI Number Information
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NPI Number | 1033740352
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Entity Type | Individual
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Provider Name | MARISSA ROBINSON
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 139 FULTON ST RM 902
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City | NEW YORK
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State | NY
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Zip | 10038-2531
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Country | US
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Telephone | 929-379-6386
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Fax |
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Provider Business Mailing Address
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Address Line | 8941 GRIFFIN WAY
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City | PIKESVILLE
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State | MD
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Zip | 21208-1424
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGP10187
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 105149-02
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License Number State | NY
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