Provider Demographics
NPI:1235339680
Name:ROBINSON, MICHELL RENEE (RAS INTERN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELL
Middle Name:RENEE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RAS INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 E ALBERTONI ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1539
Mailing Address - Country:US
Mailing Address - Phone:310-217-0616
Mailing Address - Fax:
Practice Address - Street 1:637 E ALBERTONI ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1539
Practice Address - Country:US
Practice Address - Phone:310-217-0616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)