Provider Demographics
NPI:1912654757
Name:ROBINSON, AUDREY MAUREEN (PHD, LPC-S, RPT-S)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:MAUREEN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PHD, LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 OVERLAND TRL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1741
Mailing Address - Country:US
Mailing Address - Phone:972-365-8109
Mailing Address - Fax:
Practice Address - Street 1:221 OVERLAND TRL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1741
Practice Address - Country:US
Practice Address - Phone:972-365-8109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69922101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional