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General NPI Number Information
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NPI Number | 1649455908
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Entity Type | Individual
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Provider Name | ROBYN F LIBSON
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Gender | Female
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 167 HOLLAND ST ROOM 133
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City | SOMERVILLE
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State | MA
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Zip | 02144-2401
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Country | US
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Telephone | 617-629-6668
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Fax | 617-625-6339
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Provider Business Mailing Address
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Address Line | 143 RINDGE AVE
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City | CAMBRIDGE
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State | MA
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Zip | 02140-2531
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Country | US
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Telephone | 617-629-6668
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Fax | 617-625-6339
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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