MEDICARE: ROBIN L FORE-MARTIN

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	101YP2500X	Professional Counselor	0701006935	VA

General Provider Information

NPI Number	:	1225578743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN L FORE-MARTIN

Provider Business Mailing Address
First Line	:	110 KITTY LN
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-3896
Country	:	US
Telephone Number	:	276-734-9068
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 MONTICELLO AVE
Second Line	:	SUITE 1802, #232677
City	:	NORFOLK
State	:	VA
Zip	:	23510-2670
Country	:	US
Telephone Number	:	276-734-9068
Fax Number	:

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

Provider Enumeration Date	:	03/02/2017
Last Update Date	:	03/26/2024

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