Provider Demographics
NPI:1275850422
Name:SMITH-BULL, ROBYN (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:SMITH-BULL
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 1:4917 HARRY HINES BLVD
Mailing Address - Street 2:DALLAS HEALTHY START
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7718
Mailing Address - Country:US
Mailing Address - Phone:214-590-4967
Mailing Address - Fax:214-590-1672
Practice Address - Street 1:4917 HARRY HINES BLVD
Practice Address - Street 2:DALLAS HEALTHY START
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7718
Practice Address - Country:US
Practice Address - Phone:214-590-4967
Practice Address - Fax:214-590-1672
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37902104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker