MEDICARE: MRS. ROBIN SMITH

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
1	101Y00000X	Counselor	101Y00000X	DC

General Provider Information

NPI Number	:	1144893900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN SMITH

Provider Business Mailing Address
First Line	:	4421 EDSON PL NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-4766
Country	:	US
Telephone Number	:	202-905-4818
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 CEDAR ST SE APT 102
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5012
Country	:	US
Telephone Number	:	202-497-8771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	07/20/2021

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Directions to “ MRS. ROBIN SMITH ” Practice Location

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