Provider Demographics
NPI:1043767205
Name:ROBINSON, NATASHA LYNETTE
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:LYNETTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NATSHA
Other - Middle Name:LYNETTE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1556 CAMILLE ST
Mailing Address - Street 2:1556CAMILLE ST
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71108-3515
Mailing Address - Country:US
Mailing Address - Phone:318-469-9492
Mailing Address - Fax:
Practice Address - Street 1:1556 CAMILLE ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71108-3515
Practice Address - Country:US
Practice Address - Phone:318-469-9492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor