Provider Demographics
NPI:1477879773
Name:DUBOVI, ROBIN ANNETTE (LCSW-R)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANNETTE
Last Name:DUBOVI
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CHELSEAS WALK
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1087
Mailing Address - Country:US
Mailing Address - Phone:607-257-3688
Mailing Address - Fax:
Practice Address - Street 1:33 CHELSEAS WALK
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1087
Practice Address - Country:US
Practice Address - Phone:607-257-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0299201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical