Provider Demographics
NPI:1750088464
Name:ROBERSON, FRANK LYNN
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:LYNN
Last Name:ROBERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4438 WILDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-5823
Mailing Address - Country:US
Mailing Address - Phone:817-578-6775
Mailing Address - Fax:
Practice Address - Street 1:3435 ACTON HWY
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7505
Practice Address - Country:US
Practice Address - Phone:817-578-6775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty