Provider Demographics
NPI:1265504401
Name:ROBINSON, RONALD E (LLP MASTERS)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LLP MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2848
Mailing Address - Country:US
Mailing Address - Phone:269-684-4270
Mailing Address - Fax:269-684-4070
Practice Address - Street 1:115 S SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2848
Practice Address - Country:US
Practice Address - Phone:269-684-4270
Practice Address - Fax:269-684-4070
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006710103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral