Provider Demographics
NPI:1760967855
Name:ROBINSON, PWANDRA NATALIA
Entity Type:Individual
Prefix:MISS
First Name:PWANDRA
Middle Name:NATALIA
Last Name:ROBINSON
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 1:707 YORKDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-3494
Mailing Address - Country:US
Mailing Address - Phone:662-402-6413
Mailing Address - Fax:
Practice Address - Street 1:707 YORKDALE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-3494
Practice Address - Country:US
Practice Address - Phone:662-402-6413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst