Provider Demographics
NPI:1164190336
Name:ROBINSON, PATSY MICHELLE (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:MICHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 LEISURE LN
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4339
Mailing Address - Country:US
Mailing Address - Phone:615-474-1101
Mailing Address - Fax:
Practice Address - Street 1:403 LEISURE LN
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4339
Practice Address - Country:US
Practice Address - Phone:615-474-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty