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NPI Code Detail

MEDICARE: JACLYNN ROBINSON QMHP

MEDICARE: JACLYNN ROBINSON QMHP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorTX

General Provider Information

NPI Number : 1144249814
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYNN ROBINSON QMHP
Provider Business Mailing Address
First Line : 5990 ARAPAHO RD
Second Line : APT 5O
City : DALLAS
State : TX
Zip : 75248-3715
Country : US
Telephone Number : 214-517-8803
Fax Number : 972-392-3662
Provider Business Practice Location Address
First Line : 4701 SAMUELL BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75228-6828
Country : US
Telephone Number : 214-381-7070
Fax Number : 214-381-7071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/08/2007

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