Individual
MISS TINA LYN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1 12TH ST STE 4, ASTORIA, OR 97103-4146
(312) 835-1634
(503) 325-4986
Mailing address
846 13TH AVE, SEASIDE, OR 97138-7113
(312) 835-1634
(503) 325-4986
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180006440
IL
101YP2500X
Professional Counselor
C3758
OR
101YP2500X
Professional Counselor
LH60691630
WA
Other
Enumeration date
08/11/2007
Last updated
10/04/2019
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