Provider Demographics
NPI:1831976257
Name:ROBINSON, ALYSSA GRACE I (BS)
Entity type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:GRACE
Last Name:ROBINSON
Suffix:I
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-9677
Mailing Address - Country:US
Mailing Address - Phone:606-694-9577
Mailing Address - Fax:
Practice Address - Street 1:519 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-9677
Practice Address - Country:US
Practice Address - Phone:606-694-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical