Basic Information
| Provider Information | |||||||||
| NPI: | 1689100034 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STROH | ||||||||
| FirstName: | ROBIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 POPLAR DR UNIT 35 | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975044635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5416018809 | ||||||||
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| Practice Location | |||||||||
| Address1: | 221 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975012728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417721777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2017 | ||||||||
| LastUpdateDate: | 05/04/2017 | ||||||||
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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 | 101YA0400X | 100981 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.