Provider Demographics
NPI:1629245071
Name:ROBINSON, CARLAN RICHARDS (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLAN
Middle Name:RICHARDS
Last Name:ROBINSON
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 1:1801 N FLAGLER DR APT 711
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6562
Mailing Address - Country:US
Mailing Address - Phone:516-420-1643
Mailing Address - Fax:
Practice Address - Street 1:1801 N FLAGLER DR APT 711
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6562
Practice Address - Country:US
Practice Address - Phone:516-420-1643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15453103TC0700X
FLPY8308103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical