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General NPI Number Information
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NPI Number | 1407563596
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Entity Type | Individual
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Provider Name | KIESHA MARIE ROBINSON BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 981 ORELLANA RD
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-2077
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Country | US
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Telephone | 904-788-5535
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Fax |
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Provider Business Mailing Address
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Address Line | 981 ORELLANA RD
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-2077
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Country | US
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Telephone | 904-788-5535
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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 | LBA2164
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0133004665
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 690
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License Number State | NC
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