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General NPI Number Information
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NPI Number | 1396149415
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Entity Type | Individual
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Provider Name | MALLORY E ROBINSON MA, LPC, BCBS, LBS
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 45 US -11
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City | SHAMOKIN DAM
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State | PA
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Zip | 17876
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Country | US
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Telephone | 570-931-3849
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Fax |
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Provider Business Mailing Address
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Address Line | 501 W MILL ST
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City | SELINSGROVE
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State | PA
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Zip | 17870-1627
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Country | US
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Telephone | 570-765-1825
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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