MEDICARE: ANGELA KIM ROBINSON LLC

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

General Provider Information

NPI Number	:	1992404420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELA KIM ROBINSON LLC

Provider Business Mailing Address
First Line	:	315 HIGH BROOK DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-2314
Country	:	US
Telephone Number	:	404-512-8184
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 HIGH BROOK DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-2314
Country	:	US
Telephone Number	:	404-512-8184
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ANGELA ROBINSON
Credential	:	LPC
Telephone Number	:	404-512-8184

Provider Enumeration Date	:	02/23/2023
Last Update Date	:	02/23/2023

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