Provider Demographics
NPI:1891230306
Name:ROBINSON, JENNA MARIE (BSHA)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:MARIE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:BSHA
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:MARIE
Other - Last Name:MAICKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4001 W DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4001 W DAYTON ST
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8377
Practice Address - Country:US
Practice Address - Phone:815-344-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker