Provider Demographics
NPI:1386793586
Name:GAUTHIER, ROBIN JEAN (MED)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:JEAN
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BAY ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4617
Mailing Address - Country:US
Mailing Address - Phone:978-821-4019
Mailing Address - Fax:
Practice Address - Street 1:5 BAY ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4617
Practice Address - Country:US
Practice Address - Phone:978-821-4019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health