Provider Demographics
NPI:1013584036
Name:DAVIS, ROBYN DENISE
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:DENISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3439 E ORCHID LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-7374
Mailing Address - Country:US
Mailing Address - Phone:480-937-6145
Mailing Address - Fax:
Practice Address - Street 1:3439 E ORCHID LN
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-7374
Practice Address - Country:US
Practice Address - Phone:480-937-6145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11148219174400000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No174400000XOther Service ProvidersSpecialist