Provider Demographics
NPI:1083342802
Name:ROBINSON, FREDRICK SCOT
Entity Type:Individual
Prefix:
First Name:FREDRICK
Middle Name:SCOT
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3938 LAURELLN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-8224
Mailing Address - Country:US
Mailing Address - Phone:216-446-9054
Mailing Address - Fax:
Practice Address - Street 1:3938 LAURELLN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-8224
Practice Address - Country:US
Practice Address - Phone:216-446-9054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180887251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health