Provider Demographics
NPI:1437709490
Name:TAYLOR, ROBIN SUE (MSW, ISW 13839)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW, ISW 13839
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 GREGORY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-2542
Mailing Address - Country:US
Mailing Address - Phone:813-401-5961
Mailing Address - Fax:
Practice Address - Street 1:5118 N 56TH ST STE 111
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-5440
Practice Address - Country:US
Practice Address - Phone:813-401-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW190461041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical