Provider Demographics
NPI:1346505104
Name:NEWBERRY, ROBYN BERNICE (MS)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:BERNICE
Last Name:NEWBERRY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:BERNICE
Other - Last Name:TESKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2110 IRON ST.
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-930-6063
Mailing Address - Fax:877-205-5744
Practice Address - Street 1:2110 IRON ST.
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-930-6063
Practice Address - Fax:877-205-5744
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-12-11593103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst