Provider Demographics
NPI:1760055354
Name:CHRISTAL, ROBIN K (LPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:K
Last Name:CHRISTAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 COMMUNICATION DR
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-3672
Mailing Address - Country:US
Mailing Address - Phone:573-248-1196
Mailing Address - Fax:573-248-1259
Practice Address - Street 1:146 COMMUNICATION DR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-3672
Practice Address - Country:US
Practice Address - Phone:573-248-1196
Practice Address - Fax:573-248-1259
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014034047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional