Provider Demographics
NPI:1831842921
Name:JENNIFER F ROBISON PHD LLC
Entity type:Organization
Organization Name:JENNIFER F ROBISON PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-890-0245
Mailing Address - Street 1:12481 S FORT ST STE 275
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-2106
Mailing Address - Country:US
Mailing Address - Phone:801-890-0245
Mailing Address - Fax:
Practice Address - Street 1:12481 S FORT ST STE 275
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-2106
Practice Address - Country:US
Practice Address - Phone:801-890-0245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service