Provider Demographics
NPI:1982483475
Name:ROUSSEAU-ROBINSON, RAMONA L
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:L
Last Name:ROUSSEAU-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 1:3 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4227
Mailing Address - Country:US
Mailing Address - Phone:513-505-2811
Mailing Address - Fax:
Practice Address - Street 1:3 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:OH
Practice Address - Zip Code:45215-4227
Practice Address - Country:US
Practice Address - Phone:513-505-2811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOCPSA161887101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty