Provider Demographics
NPI:1952903312
Name:ROBBINS, DANIQUE
Entity Type:Individual
Prefix:
First Name:DANIQUE
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 S 4TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-2341
Mailing Address - Country:US
Mailing Address - Phone:502-408-2577
Mailing Address - Fax:
Practice Address - Street 1:1359 S 4TH ST APT 4
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-2341
Practice Address - Country:US
Practice Address - Phone:502-408-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101Y00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No101Y00000XBehavioral Health & Social Service ProvidersCounselor