=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184380990
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. ERIN NICOLE ROBISON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2021
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 VIRGINIA AVE N STE 1
-----------------------------------------------------
City | TIFTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31794-4268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-396-5507
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 BETHEL CHURCH RD
-----------------------------------------------------
City | SUMNER
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31789-4521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-292-9521
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | AMFT000715
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------