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General NPI Number Information
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NPI Number | 1245066455
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Entity Type | Individual
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Provider Name | EDEN ANN ROBINSON
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Gender | Female
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 410 W GRAND AVE
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City | MARSHALL
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State | TX
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Zip | 75670-3235
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Country | US
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Telephone | 903-935-2099
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Fax |
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Provider Business Mailing Address
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Address Line | 104 E CEDAR ST
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City | HALLSVILLE
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State | TX
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Zip | 75650-6134
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Country | US
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Telephone | 903-424-2691
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 18615694
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License Number State | TX
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