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NPI 1710871678

NPI 1710871678 : BETHANY RICHARDES ROBINSON : AVON, IN

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General NPI Number Information
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    NPI Number           |    1710871678
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    Entity Type          |    Individual 
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    Provider Name        |    BETHANY RICHARDES ROBINSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/05/2025
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    Last Update Date     |    06/05/2025
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Provider Practice Location Address
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    Address Line         |    6655 E US HIGHWAY 36 
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    City                 |    AVON
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    State                |    IN
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    Zip                  |    46123-8923
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    Country              |    US
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    Telephone            |    888-714-1927
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7096 LANCASTER LN 
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    City                 |    AVON
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    State                |    IN
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    Zip                  |    46123-9341
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    Country              |    US
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    Telephone            |    317-661-0888
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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        |    1041S0200X
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    Taxonomy Name        |    School Social Worker
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    License Number       |    99131050A
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    License Number State |    IN
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