Provider Demographics
NPI:1326361502
Name:DALSKE, ROBIN L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:DALSKE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:DALSKE-CLARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:310 W LOSEY ST
Mailing Address - Street 2:
Mailing Address - City:SCOTT AFB
Mailing Address - State:IL
Mailing Address - Zip Code:62225-5250
Mailing Address - Country:US
Mailing Address - Phone:618-256-7386
Mailing Address - Fax:618-256-7299
Practice Address - Street 1:310 W LOSEY ST
Practice Address - Street 2:
Practice Address - City:SCOTT AFB
Practice Address - State:IL
Practice Address - Zip Code:62225-5250
Practice Address - Country:US
Practice Address - Phone:618-256-7386
Practice Address - Fax:618-256-7299
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TP2701X, 106H00000X, 103TB0200X, 103TC2200X, 103TF0000X, 103TA0400X
IL071.007139103TC0700X
MO2006029876103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)