Provider Demographics
NPI:1083737456
Name:ROBBINS, DONNA LOUISE (LIC CLIN PSYCHOLOG)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LOUISE
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:LIC CLIN PSYCHOLOG
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:LOUISE
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LIC CLIN PSYCHOLOG
Mailing Address - Street 1:42 FAIRMONT AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2506
Mailing Address - Country:US
Mailing Address - Phone:617-332-2611
Mailing Address - Fax:
Practice Address - Street 1:42 FAIRMONT AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2506
Practice Address - Country:US
Practice Address - Phone:617-332-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA703103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical