Provider Demographics
NPI:1881029957
Name:TATE, ROBYN MICHELE
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:MICHELE
Last Name:TATE
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 1:672 W 400 S
Mailing Address - Street 2:STE 201
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-3170
Mailing Address - Country:US
Mailing Address - Phone:801-369-8989
Mailing Address - Fax:801-704-9741
Practice Address - Street 1:5250 S COMMERCE DR
Practice Address - Street 2:STE 250
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7926
Practice Address - Country:US
Practice Address - Phone:801-261-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9039380-35011041C0700X
UT261QM0801X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health