Provider Demographics
NPI:1588942726
Name:ROBINSON, LESLI (MSW)
Entity type:Individual
Prefix:
First Name:LESLI
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29475 BOBRICH ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3403
Mailing Address - Country:US
Mailing Address - Phone:734-744-7711
Mailing Address - Fax:
Practice Address - Street 1:29475 BOBRICH ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3403
Practice Address - Country:US
Practice Address - Phone:734-744-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801059797101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health