Provider Demographics
NPI:1992383053
Name:ROBINSON, EMMA (RBT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 NOBLE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-5544
Mailing Address - Country:US
Mailing Address - Phone:260-420-9332
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:601 NOBLE DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-5544
Practice Address - Country:US
Practice Address - Phone:260-420-9332
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-20-134707106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician