Provider Demographics
NPI:1154167047
Name:ROBINSON, MIRIAM LEAH
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:LEAH
Last Name:ROBINSON
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 1:6514 PEBBLE BROOKE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3857
Mailing Address - Country:US
Mailing Address - Phone:443-605-2547
Mailing Address - Fax:
Practice Address - Street 1:6514 PEBBLE BROOKE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3857
Practice Address - Country:US
Practice Address - Phone:443-605-2547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician