Provider Demographics
NPI:1164182739
Name:ROBINSON, DOROTHY ROSE
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ROSE
Last Name:ROBINSON
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:UVM-CVMC FAMILY MEDICINE -WATERBURY
Mailing Address - Street 2:130 SOUTH MAIN STREET
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676
Mailing Address - Country:US
Mailing Address - Phone:802-244-7874
Mailing Address - Fax:802-244-4106
Practice Address - Street 1:CVMC-FAMILY MEDICINE WATERBURY
Practice Address - Street 2:130 SOUTH MAIN STREET
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676
Practice Address - Country:US
Practice Address - Phone:802-244-7874
Practice Address - Fax:802-244-4106
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker