Provider Demographics
NPI:1669153912
Name:ROBINSON, TIANA (MAS-MFT)
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MAS-MFT
Other - Prefix:
Other - First Name:TIANA
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:275 W JUNIPER AVE APT 2081
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3930
Mailing Address - Country:US
Mailing Address - Phone:480-248-4161
Mailing Address - Fax:
Practice Address - Street 1:1801 S EXTENSION RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-5969
Practice Address - Country:US
Practice Address - Phone:480-900-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health