Provider Demographics
NPI:1619486750
Name:ROBINSON-NELSON, RUTH (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:ROBINSON-NELSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 WOODCREST DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2440
Mailing Address - Country:US
Mailing Address - Phone:651-357-6751
Mailing Address - Fax:
Practice Address - Street 1:300 CREEK VIEW RD STE 101
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-8547
Practice Address - Country:US
Practice Address - Phone:302-307-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0001120103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist