Provider Demographics
NPI:1992736136
Name:LETT, ROBIN MARGARET (PHD, HSPP)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:MARGARET
Last Name:LETT
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ROBIN
Other - Last Name:LETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1904 W. ROYALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2264
Mailing Address - Country:US
Mailing Address - Phone:765-284-0043
Mailing Address - Fax:765-284-4112
Practice Address - Street 1:1904 W. ROYALE DRIVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2264
Practice Address - Country:US
Practice Address - Phone:765-284-0443
Practice Address - Fax:765-284-4112
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041851A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000360940OtherBCBS
IN000000033877OtherMPLAN
IN742186000OtherMAGELLAN