Individual
MR. JACOB HEATH ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC, QMHP-A
Contact information
Practice address
266 GREEN VALLEY CT, CHILHOWIE, VA 24319-3696
(276) 274-7242
Mailing address
266 GREEN VALLEY CT, CHILHOWIE, VA 24319-3696
(276) 274-7242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710103576
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0710103576
—
VA
Enumeration date
01/26/2021
Last updated
01/26/2021
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