Individual
ROBIN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
240030
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-079-005
STATE HOME HEALTHLICENSE
KS
Enumeration date
02/27/2024
Last updated
09/19/2024
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