Individual
JONATHAN ROBBELOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
503 E STERLING CANYON DR, VAIL, AZ 85641-2289
(520) 304-9422
Mailing address
1161 N EL DORADO PL STE 103, TUCSON, AZ 85715-4607
(520) 748-7108
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
6173528
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
972921
—
AZ
Enumeration date
12/02/2014
Last updated
08/11/2021
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