Provider Demographics
NPI:1003117920
Name:WALSH, ROBYN JONVIEVE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:JONVIEVE
Last Name:WALSH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-5215
Mailing Address - Country:US
Mailing Address - Phone:708-436-1047
Mailing Address - Fax:847-934-3446
Practice Address - Street 1:311 N FREMONT ST
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-5215
Practice Address - Country:US
Practice Address - Phone:708-436-1047
Practice Address - Fax:847-934-3446
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.005985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical