Provider Demographics
NPI:1588379499
Name:BLAIN, ROBIN (QMHS)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:BLAIN
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 RAVINE PARK VLG
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-4905
Mailing Address - Country:US
Mailing Address - Phone:313-488-9921
Mailing Address - Fax:
Practice Address - Street 1:71 RAVINE PARK VLG
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-4905
Practice Address - Country:US
Practice Address - Phone:313-488-9921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health