Provider Demographics
NPI:1891183463
Name:ROBINSON, TRICIA (PSYD)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10403
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80932-1403
Mailing Address - Country:US
Mailing Address - Phone:410-269-9954
Mailing Address - Fax:
Practice Address - Street 1:5136 COMMUNITY CENTER DR
Practice Address - Street 2:
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-3002
Practice Address - Country:US
Practice Address - Phone:719-333-5177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004707103TC0700X
MD05805103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical