Provider Demographics
NPI:1306419635
Name:ROBLE, TERESA ANNETTE
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANNETTE
Last Name:ROBLE
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 1:935 JAMELL DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-9041
Mailing Address - Country:US
Mailing Address - Phone:724-875-1098
Mailing Address - Fax:
Practice Address - Street 1:935 JAMELL DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9041
Practice Address - Country:US
Practice Address - Phone:724-875-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001289106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist