Provider Demographics
NPI:1053867606
Name:ROBBINS, HEIDI LYNN (MA)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:LYNN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 HOSPITAL LOOP
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:VT
Mailing Address - Zip Code:05602-9105
Mailing Address - Country:US
Mailing Address - Phone:802-479-4083
Mailing Address - Fax:802-476-1476
Practice Address - Street 1:174 HOSPITAL LOOP
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9105
Practice Address - Country:US
Practice Address - Phone:802-479-4083
Practice Address - Fax:802-476-1476
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047.0119442103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist