Provider Demographics
NPI:1548906811
Name:ROBINSON, CHRISTOPHER JORDAN
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JORDAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 WARMSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5374
Mailing Address - Country:US
Mailing Address - Phone:702-472-0159
Mailing Address - Fax:
Practice Address - Street 1:9089 S PECOS RD STE 3600
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7186
Practice Address - Country:US
Practice Address - Phone:702-680-1526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician