Provider Demographics
NPI:1003180878
Name:EDISON, ROBIN DAWN (MED, LPC, NCC, CAADC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:DAWN
Last Name:EDISON
Suffix:
Gender:F
Credentials:MED, LPC, NCC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5656 LE BLANC AVENUE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103
Mailing Address - Country:US
Mailing Address - Phone:248-520-0880
Mailing Address - Fax:
Practice Address - Street 1:5656 LE BLANC AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9394
Practice Address - Country:US
Practice Address - Phone:248-520-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009507101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)