Provider Demographics
NPI:1225578743
Name:FORE-MARTIN, ROBIN L
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:FORE-MARTIN
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 1:110 KITTY LN
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-3896
Mailing Address - Country:US
Mailing Address - Phone:276-734-9068
Mailing Address - Fax:
Practice Address - Street 1:440 MONTICELLO AVE
Practice Address - Street 2:SUITE 1802, #232677
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2670
Practice Address - Country:US
Practice Address - Phone:276-734-9068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional