Provider Demographics
NPI:1376007856
Name:ROBBINS, MONA LEE (L AC)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:LEE
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 WATSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3717
Mailing Address - Country:US
Mailing Address - Phone:612-845-5588
Mailing Address - Fax:
Practice Address - Street 1:6053 HUDSON RD STE 225
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1026
Practice Address - Country:US
Practice Address - Phone:651-560-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1720171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist