Provider Demographics
NPI:1083704266
Name:STILWELL, ROBIN KAYE (MA)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:KAYE
Last Name:STILWELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 W BOYNTON BEACH BLVD 1B #320
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3497
Mailing Address - Country:US
Mailing Address - Phone:305-275-2339
Mailing Address - Fax:561-769-4255
Practice Address - Street 1:1313 W BOYNTON BEACH BLVD 1B #320
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3497
Practice Address - Country:US
Practice Address - Phone:305-275-2339
Practice Address - Fax:561-769-4255
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT262106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist