Provider Demographics
NPI:1235385337
Name:HOLMES-SULLIVAN, ROBIN HELENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:HELENE
Last Name:HOLMES-SULLIVAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:HELENE
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1375 W 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2091
Mailing Address - Country:US
Mailing Address - Phone:541-485-3876
Mailing Address - Fax:
Practice Address - Street 1:328 W BROADWAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2826
Practice Address - Country:US
Practice Address - Phone:541-346-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1263103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical