Provider Demographics
NPI:1770850240
Name:ROBINSON, LATRICIA JOY
Entity Type:Individual
Prefix:
First Name:LATRICIA
Middle Name:JOY
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 1:80 YALE ST
Mailing Address - Street 2:UNIT 10
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-1564
Mailing Address - Country:US
Mailing Address - Phone:203-522-5098
Mailing Address - Fax:
Practice Address - Street 1:203 HIGH ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3250
Practice Address - Country:US
Practice Address - Phone:203-874-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical