Provider Demographics
NPI:1063422764
Name:PATTON, ROBIN J
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:J
Last Name:PATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 CHURCHILL CT
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-4711
Mailing Address - Country:US
Mailing Address - Phone:314-541-4925
Mailing Address - Fax:636-337-5230
Practice Address - Street 1:1132 CHURCHILL CT
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-4711
Practice Address - Country:US
Practice Address - Phone:314-541-4925
Practice Address - Fax:636-337-5230
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health