Provider Demographics
NPI:1902102320
Name:KOSER, ROBYN LAURELLE (MED)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:LAURELLE
Last Name:KOSER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:FOLSOM
Other - Last Name:KOSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:1290 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-8623
Mailing Address - Country:US
Mailing Address - Phone:251-625-0118
Mailing Address - Fax:251-625-0116
Practice Address - Street 1:1290 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-8623
Practice Address - Country:US
Practice Address - Phone:251-625-0118
Practice Address - Fax:251-625-0116
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2899101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health