Provider Demographics
NPI:1659626273
Name:THOMPSON, ROBYN E (BCABA)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13448 FULTON
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-5766
Mailing Address - Country:US
Mailing Address - Phone:574-596-3155
Mailing Address - Fax:
Practice Address - Street 1:13448 FULTON
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-5766
Practice Address - Country:US
Practice Address - Phone:574-596-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0-12-5015103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst