Provider Demographics
NPI:1376024737
Name:HALL, ROBYN KATHLEEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:KATHLEEN
Last Name:HALL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ROBYN
Other - Middle Name:KATHLEEN HALL
Other - Last Name:GALBRAITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4115 EAST VALLEY AUTO DRIVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:602-400-9664
Mailing Address - Fax:480-507-1803
Practice Address - Street 1:4115 EAST VALLEY AUTO DRIVE
Practice Address - Street 2:SUITE 208
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:602-400-9664
Practice Address - Fax:480-507-1803
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005008103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist