Provider Demographics
NPI:1326540287
Name:FITZPATRICK, ROBIN S (EDS, MED)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:S
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:EDS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 LONGDALE DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-4741
Mailing Address - Country:US
Mailing Address - Phone:757-852-4555
Mailing Address - Fax:757-852-4550
Practice Address - Street 1:1335 LONGDALE DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-4741
Practice Address - Country:US
Practice Address - Phone:757-852-4555
Practice Address - Fax:757-852-4550
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0813000039103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool