Provider Demographics
NPI:1518682913
Name:ROBINETTE, KATRINA MARIE
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARIE
Last Name:ROBINETTE
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 1:105 STARLING CIR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-1138
Mailing Address - Country:US
Mailing Address - Phone:815-528-0883
Mailing Address - Fax:
Practice Address - Street 1:41W400 SILVER GLEN RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-8453
Practice Address - Country:US
Practice Address - Phone:331-901-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150108383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health