Basic Information
| Provider Information | |||||||||
| NPI: | 1124640800 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBINSON-SNEAD | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | RICK | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 PAR HAVEN DR APT D24 | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199043337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023442604 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1058 S GOVERNORS AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199046920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023828698 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2020 | ||||||||
| LastUpdateDate: | 05/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.