Provider Demographics
NPI:1164585238
Name:GIPPS, ROBIN EUGENE (LMFT)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:EUGENE
Last Name:GIPPS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 NE 61ST CT
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2155
Mailing Address - Country:US
Mailing Address - Phone:954-471-3372
Mailing Address - Fax:954-441-3882
Practice Address - Street 1:18503 PINES BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1404
Practice Address - Country:US
Practice Address - Phone:954-471-3372
Practice Address - Fax:954-441-3882
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1666106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist