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General NPI Number Information
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NPI Number | 1366469702
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Entity Type | Individual
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Provider Name | KERSTIN LEE ROBINETTE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 112 W KENOSHA ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-8901
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Country | US
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Telephone | 918-259-1118
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Fax | 918-259-3507
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Provider Business Mailing Address
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Address Line | PO BOX 1444
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City | BROKEN ARROW
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State | OK
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Zip | 74013-1444
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Country | US
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Telephone | 918-259-1118
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Fax | 918-259-3507
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 843
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License Number State | OK
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