Basic Information
| Provider Information | |||||||||
| NPI: | 1558592436 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARISTIL | ||||||||
| FirstName: | ROBENSON | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6104 WILLOUGHBY CIR | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334639308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612515320 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1639 FORUM PL | ||||||||
| Address2: | SUITE # 7 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334012330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617128821 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2009 | ||||||||
| LastUpdateDate: | 07/27/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.