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General NPI Number Information
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NPI Number | 1407185929
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Entity Type | Individual
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Provider Name | MRS. MYRA NADINE ROBINSON
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Gender | Female
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4441 BRAGG BLVD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-3862
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Country | US
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Telephone | 910-527-8474
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Fax |
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Provider Business Mailing Address
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Address Line | 7017 BUCKTAIL RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-9351
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Country | US
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Telephone | 910-822-6541
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7627
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License Number State | NC
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