Provider Demographics
NPI:1831452960
Name:KLIMPL MILLER, ROBYN
Entity type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:
Last Name:KLIMPL MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 FORT WASHINGTON AVE
Mailing Address - Street 2:22B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-2054
Mailing Address - Country:US
Mailing Address - Phone:917-750-1211
Mailing Address - Fax:
Practice Address - Street 1:570 FORT WASHINGTON AVE
Practice Address - Street 2:22B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-2054
Practice Address - Country:US
Practice Address - Phone:917-750-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NY545501174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist