=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376950188
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CURTISS HOWARD ROBINSON MA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2014
-----------------------------------------------------
Last Update Date | 04/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 575 CLUB LN STE 103
-----------------------------------------------------
City | CONWAY
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72034-3681
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-873-0190
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 575 CLUB LN STE 103
-----------------------------------------------------
City | CONWAY
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72034-3680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-515-4788
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | A1602021
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------