Provider Demographics
NPI:1336623016
Name:ROBINSON, TAMARA LYNN
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYNN
Last Name:ROBINSON
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:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TN
Mailing Address - Zip Code:38474-0062
Mailing Address - Country:US
Mailing Address - Phone:931-797-8305
Mailing Address - Fax:
Practice Address - Street 1:1510 HATCHER LN STE 1
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4813
Practice Address - Country:US
Practice Address - Phone:931-548-9315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1259101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)