Provider Demographics
NPI:1801654942
Name:ROBINSON, BRANDY SHAWNTE (RDH/PMUA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:SHAWNTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RDH/PMUA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 WIMBLEDON WAY
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-5512
Mailing Address - Country:US
Mailing Address - Phone:856-637-7772
Mailing Address - Fax:
Practice Address - Street 1:2001 COLLEGE DR STE 19
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-5617
Practice Address - Country:US
Practice Address - Phone:856-784-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty