Provider Demographics
NPI:1407184500
Name:MONK, ROBIN (MA)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:MONK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3192 COUNTY ROAD 521B
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34785-8096
Mailing Address - Country:US
Mailing Address - Phone:352-748-8028
Mailing Address - Fax:
Practice Address - Street 1:3192 COUNTY ROAD 521B
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-8096
Practice Address - Country:US
Practice Address - Phone:352-748-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health