Provider Demographics
NPI:1811011828
Name:ROBINSON, PAUL E (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3077 POSSUM RUN RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-7506
Mailing Address - Country:US
Mailing Address - Phone:419-756-9026
Mailing Address - Fax:419-756-9026
Practice Address - Street 1:3077 POSSUM RUN RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-7506
Practice Address - Country:US
Practice Address - Phone:419-756-9026
Practice Address - Fax:419-756-9026
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH791103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0395844Medicaid
OH0395844Medicaid