Provider Demographics
NPI:1821396029
Name:ROBINSON, TAHLIA COZZENS (LCSW)
Entity Type:Individual
Prefix:
First Name:TAHLIA
Middle Name:COZZENS
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 N MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-4014
Mailing Address - Country:US
Mailing Address - Phone:801-472-1724
Mailing Address - Fax:
Practice Address - Street 1:1220 N MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-4014
Practice Address - Country:US
Practice Address - Phone:801-472-1724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7675564-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical