Provider Demographics
NPI:1740739408
Name:ROBINSON, THEO II (MS)
Entity Type:Individual
Prefix:
First Name:THEO
Middle Name:
Last Name:ROBINSON
Suffix:II
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 S FRASER ST APT 12-107
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4743
Mailing Address - Country:US
Mailing Address - Phone:772-766-2538
Mailing Address - Fax:
Practice Address - Street 1:2170 S PARKER RD STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5734
Practice Address - Country:US
Practice Address - Phone:720-706-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
FL1-16-23155103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other