Provider Demographics
NPI:1952529349
Name:ROBINSON, LESLIE MICHELLE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MICHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:MICHELLE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2850 S SUGAR MILL LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:47949-8036
Mailing Address - Country:US
Mailing Address - Phone:765-397-3607
Mailing Address - Fax:
Practice Address - Street 1:707 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4360
Practice Address - Country:US
Practice Address - Phone:217-446-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist