Provider Demographics
NPI:1235331885
Name:HENRY-PEARL, ROBIN D (CLMT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:HENRY-PEARL
Suffix:
Gender:F
Credentials:CLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GRETA WAY
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2644
Mailing Address - Country:US
Mailing Address - Phone:207-409-0140
Mailing Address - Fax:
Practice Address - Street 1:449 FOREST AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2029
Practice Address - Country:US
Practice Address - Phone:207-409-0140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT1834174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist