Provider Demographics
NPI:1871852467
Name:JENKINS, ROBYN MARIE (MS)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:MARIE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 TAYLOR ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-3751
Mailing Address - Country:US
Mailing Address - Phone:952-454-0948
Mailing Address - Fax:
Practice Address - Street 1:4255 PHEASANT RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4537
Practice Address - Country:US
Practice Address - Phone:763-703-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health