Provider Demographics
NPI:1003227786
Name:ROBERSON, DOVEY MIA'TEE
Entity Type:Individual
Prefix:MRS
First Name:DOVEY
Middle Name:MIA'TEE
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DOVEY
Other - Middle Name:MIA'TEE
Other - Last Name:HOUSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 PLAYFIELD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-4519
Mailing Address - Country:US
Mailing Address - Phone:706-366-8417
Mailing Address - Fax:
Practice Address - Street 1:1230 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-5241
Practice Address - Country:US
Practice Address - Phone:706-321-9606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health Worker