Provider Demographics
NPI:1063742799
Name:PFOHL, ROBIN S (LPC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:S
Last Name:PFOHL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:AZ
Mailing Address - Zip Code:85173-1306
Mailing Address - Country:US
Mailing Address - Phone:520-560-6984
Mailing Address - Fax:520-689-5104
Practice Address - Street 1:4111 E VALLEY AUTO DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4605
Practice Address - Country:US
Practice Address - Phone:520-560-6984
Practice Address - Fax:520-689-5104
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ-11044101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional