Provider Demographics
NPI:1932401197
Name:ZOLLAR, ROBIN R (L,M,SW)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:R
Last Name:ZOLLAR
Suffix:
Gender:F
Credentials:L,M,SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-0500
Mailing Address - Country:US
Mailing Address - Phone:269-983-4242
Mailing Address - Fax:269-983-4242
Practice Address - Street 1:515 SHIP ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1180
Practice Address - Country:US
Practice Address - Phone:269-983-4242
Practice Address - Fax:269-983-4242
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-21
Last Update Date:2010-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010175641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical