Provider Demographics
NPI:1962189365
Name:ROBINSON, JONI LEIGH (BS)
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:LEIGH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 E MAIN ST APT B206
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5827
Mailing Address - Country:US
Mailing Address - Phone:615-684-2745
Mailing Address - Fax:
Practice Address - Street 1:317 E MAIN ST APT B206B5
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-5822
Practice Address - Country:US
Practice Address - Phone:615-684-2745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNBACB916736106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician