Provider Demographics
NPI:1578284345
Name:HUMBARD, ROBIN LYNNE
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNNE
Last Name:HUMBARD
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 1:377 S OVERLOOK ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-4567
Mailing Address - Country:US
Mailing Address - Phone:913-914-8306
Mailing Address - Fax:
Practice Address - Street 1:110 S CHERRY ST STE 200
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-3441
Practice Address - Country:US
Practice Address - Phone:913-914-8306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional