Provider Demographics
NPI:1508644014
Name:ROBINSON, KENDRA MICHELLE
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MICHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 OLD VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5524
Mailing Address - Country:US
Mailing Address - Phone:207-299-3646
Mailing Address - Fax:
Practice Address - Street 1:3890 DUNN AVE STE 1104
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-6432
Practice Address - Country:US
Practice Address - Phone:904-367-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor