Provider Demographics
NPI:1871902924
Name:ROBINSON, GI GI L
Entity type:Individual
Prefix:
First Name:GI GI
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 KINGS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-7420
Mailing Address - Country:US
Mailing Address - Phone:706-575-6796
Mailing Address - Fax:706-596-5727
Practice Address - Street 1:1422 KINGS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-7420
Practice Address - Country:US
Practice Address - Phone:706-575-6796
Practice Address - Fax:706-596-5727
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-03
Last Update Date:2014-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA333600000XMedicaid