Basic Information
| Provider Information | |||||||||
| NPI: | 1598981417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEYER | ||||||||
| FirstName: | ROBYN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC-IT | ||||||||
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| Mailing Information | |||||||||
| Address1: | W6976 NEWTON RD | ||||||||
| Address2: | |||||||||
| City: | FOND DU LAC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549379456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9209489685 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 40 CAMELOT DR | ||||||||
| Address2: | |||||||||
| City: | FOND DU LAC | ||||||||
| State: | WI | ||||||||
| PostalCode: | 549358049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9209078201 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 08/13/2015 | ||||||||
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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 | 101YP2500X | 1009-226 | WI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.