Individual
STACEY ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 FOSTER ST UNIT 13, BROCKTON, MA 02301-5974
(561) 516-4404
Mailing address
17 FOSTER ST UNIT 13, BROCKTON, MA 02301-5974
(561) 516-4404
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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