Provider Demographics
NPI:1467986752
Name:GAMBLE, ROBIN MICHELLE
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MICHELLE
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ROBIN
Other - Middle Name:MICHELLE
Other - Last Name:FULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7655 GOLDEN LANTERN CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5331
Mailing Address - Country:US
Mailing Address - Phone:517-499-8237
Mailing Address - Fax:
Practice Address - Street 1:7455 ARROYO CROSS PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4085
Practice Address - Country:US
Practice Address - Phone:702-761-6467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health