Basic Information
| Provider Information | |||||||||
| NPI: | 1003140450 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON | ||||||||
| FirstName: | JEANNE | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, LPC,MHSP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1724 COUNTRY CLUB DR | ||||||||
| Address2: | |||||||||
| City: | TULLAHOMA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373884825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233123364 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11133 TULLAHOMA HWY | ||||||||
| Address2: | |||||||||
| City: | TULLAHOMA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373886016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9314549994 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2009 | ||||||||
| LastUpdateDate: | 06/15/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2541 | TN | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.