MEDICARE: MRS. JANET LEE ROBLES MA, LPC

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	448	CO

General Provider Information

NPI Number	:	1639300510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET LEE ROBLES MA, LPC

Provider Business Mailing Address
First Line	:	411 S TEJON ST
Second Line	:	SUITE G
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2159
Country	:	US
Telephone Number	:	719-634-4171
Fax Number	:	719-689-0735

Provider Business Practice Location Address
First Line	:	411 S TEJON ST
Second Line	:	SUITE G
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2159
Country	:	US
Telephone Number	:	719-634-4171
Fax Number	:	719-689-0735

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

Provider Enumeration Date	:	07/27/2009
Last Update Date	:	01/16/2010

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