Provider Demographics
NPI:1982225199
Name:ROBINSON, TIERRA BRIANNA
Entity Type:Individual
Prefix:MRS
First Name:TIERRA
Middle Name:BRIANNA
Last Name:ROBINSON
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 1:2005 N 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4531
Mailing Address - Country:US
Mailing Address - Phone:773-690-1681
Mailing Address - Fax:
Practice Address - Street 1:10320 W MCDOWELL RD BLDG G
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4863
Practice Address - Country:US
Practice Address - Phone:623-215-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health