MEDICARE: ALEXIS ROBINSON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	225C00000X	Rehabilitation Counselor
3	101Y00000X	Counselor

General Provider Information

NPI Number	:	1831600659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS ROBINSON

Provider Business Mailing Address
First Line	:	307 BROOKEDGE DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2416
Country	:	US
Telephone Number	:	804-324-8686
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 BROOKEDGE DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2416
Country	:	US
Telephone Number	:	804-324-8686
Fax Number	:

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

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	10/19/2017

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