Provider Demographics
NPI:1992492185
Name:TERRELL ROBINSON, TOMEKIA
Entity type:Individual
Prefix:
First Name:TOMEKIA
Middle Name:
Last Name:TERRELL ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 GROOVER ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-3746
Mailing Address - Country:US
Mailing Address - Phone:229-344-8689
Mailing Address - Fax:
Practice Address - Street 1:160 GROOVER ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-3746
Practice Address - Country:US
Practice Address - Phone:229-344-8689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator