Provider Demographics
NPI:1043465719
Name:ROBB, DANIEL A (MA, LPC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:ROBB
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 TRAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-2715
Mailing Address - Country:US
Mailing Address - Phone:636-219-7524
Mailing Address - Fax:
Practice Address - Street 1:395 TRAVIS BLVD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-2715
Practice Address - Country:US
Practice Address - Phone:636-219-7524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-23
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006012620101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional