Provider Demographics
NPI:1619243219
Name:ROBB, KRISTY L (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:L
Last Name:ROBB
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E LONGVIEW DR STE C
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-2102
Mailing Address - Country:US
Mailing Address - Phone:920-737-0022
Mailing Address - Fax:
Practice Address - Street 1:420 E LONGVIEW DR STE C
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2102
Practice Address - Country:US
Practice Address - Phone:920-737-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8139-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical