Doctor Name: | MARIA ROBLES |
NPI Number: | 1013364553 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 01735 |
Business Practice Address: | 4050 Coon Rapids Blvd Nw 505 Coon Rapids, MN - 554332522 |
Business Phone Number: | 7632367964 |
Business Fax Number: | |
Mailing Address: | 4050 Coon Rapids Blvd Nw, 505 COON RAPIDS |
State: | MN |
Postal Code: | 554332522 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/14/2016 |
NPI Last Update Date: | 05/14/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 01735 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |