Provider Demographics
NPI:1720680358
Name:ROBINSON, MADRIKA D (N/A)
Entity Type:Individual
Prefix:MS
First Name:MADRIKA
Middle Name:D
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 JADEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-2711
Mailing Address - Country:US
Mailing Address - Phone:913-508-8276
Mailing Address - Fax:
Practice Address - Street 1:1024 JADEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-2711
Practice Address - Country:US
Practice Address - Phone:913-508-8276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst