Provider Demographics
NPI:1164214151
Name:ROBINSON, DION JASON
Entity type:Individual
Prefix:
First Name:DION
Middle Name:JASON
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 1:2020 AVALON PKWY STE 345
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3054
Mailing Address - Country:US
Mailing Address - Phone:404-996-9870
Mailing Address - Fax:
Practice Address - Street 1:2020 AVALON PKWY STE 345
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3054
Practice Address - Country:US
Practice Address - Phone:404-996-9870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25097941251C00000X, 251S00000X, 174200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health