Basic Information
| Provider Information | |||||||||
| NPI: | 1134239973 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOBIN | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MS,CRC,CADAC II, | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 124 | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010830124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134369816 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 72 JAQUES AVE | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016102476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088601083 | ||||||||
| FaxNumber: | 5088601030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 12/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 026715 | MA | N | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | 0645AL | MA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.